{"hospital_name":"Pickerington Methodist Hospital","last_updated_on":"2026-04-01","version":"3.0.0","location_name":["Pickerington Methodist Hospital"],"hospital_address":["1010 Refugee Rd, Pickerington, OH 43147"],"license_information":{"license_number":"1173LH","state":"OH"},"type_2_npi":["1972535052"],"attestation":{"attestation":"To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.","confirm_attestation":true,"attester_name":"Girish Dighe"},"modifier_information":[{"description":"Bilateral Procedure","code":"50","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Allwell","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Amerihealth","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Community Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Great West Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"First Health/Coventry","plan_name":"First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual of Ohio","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual of Ohio","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual of Ohio","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual of Ohio","plan_name":"Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medigold","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice Plan","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Options Other Commercial Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Drug amount discarded/not administered to any patient","code":"JW","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Allwell","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Amerihealth","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Community Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Great West Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"First Health/Coventry","plan_name":"First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual of Ohio","plan_name":"All Commercial 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Plan","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Options Other Commercial Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Technical Component; represents the costs of equipment, supplies, and technician personnel for a procedure, excluding the physician's interpretation. It is used when only the technical portion of a test is billed, typically by hospitals, imaging centers, or independent diagnostic testing facilities","code":"TC","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Allwell","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Amerihealth","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Blue Access HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Community Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Caresource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"Great West Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"First Health/Coventry","plan_name":"First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual of Ohio","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual of Ohio","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual of Ohio","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual of Ohio","plan_name":"Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medigold","plan_name":"Medicare Managed Care 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value."},{"payer_name":"UnitedHealthCare","plan_name":"Options Other Commercial Plan","description":"The modified price is presented in the standard charge value."}]}],"standard_charge_information":[{"description":"Hc Room And Bed Private Med Surg Or Gyn","code_information":[{"code":"11100001","type":"CDM"},{"code":"111","type":"RC"}],"standard_charges":[{"gross_charge":2832.0,"discounted_cash":1840.8,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Room And Bed Ip Only Periop Discharge","code_information":[{"code":"11100002","type":"CDM"},{"code":"111","type":"RC"}],"standard_charges":[{"gross_charge":1.0,"discounted_cash":0.65,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Room And Bed Private Ob","code_information":[{"code":"11200001","type":"CDM"},{"code":"112","type":"RC"}],"standard_charges":[{"gross_charge":2832.0,"discounted_cash":1840.8,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Room And Bed Private Psych","code_information":[{"code":"11400001","type":"CDM"},{"code":"114","type":"RC"}],"standard_charges":[{"gross_charge":2928.0,"discounted_cash":1903.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Room And Bed Private Oncology","code_information":[{"code":"11700001","type":"CDM"},{"code":"117","type":"RC"}],"standard_charges":[{"gross_charge":2832.0,"discounted_cash":1840.8,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Room And Bed Semi Private Med Surg Or Gyn","code_information":[{"code":"12100001","type":"CDM"},{"code":"121","type":"RC"}],"standard_charges":[{"gross_charge":2832.0,"discounted_cash":1840.8,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Room And Bed Semi Private Ob","code_information":[{"code":"12200001","type":"CDM"},{"code":"122","type":"RC"}],"standard_charges":[{"gross_charge":2832.0,"discounted_cash":1840.8,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Room And Bed Semi Private Psych","code_information":[{"code":"12400001","type":"CDM"},{"code":"124","type":"RC"}],"standard_charges":[{"gross_charge":2928.0,"discounted_cash":1903.2,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Room And Bed Semi Private Rehab","code_information":[{"code":"12800001","type":"CDM"},{"code":"128","type":"RC"}],"standard_charges":[{"gross_charge":2832.0,"discounted_cash":1840.8,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Asoc Routine Care","code_information":[{"code":"15100001","type":"CDM"},{"code":"151","type":"RC"}],"standard_charges":[{"gross_charge":1509.0,"discounted_cash":980.85,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Room And Bed Nursery General","code_information":[{"code":"17000001","type":"CDM"},{"code":"170","type":"RC"}],"standard_charges":[{"gross_charge":2725.0,"discounted_cash":1771.25,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Special Care Nursery Level 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Intermediate","code_information":[{"code":"20600001","type":"CDM"},{"code":"206","type":"RC"}],"standard_charges":[{"gross_charge":5054.0,"discounted_cash":3285.1,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Room And Bed Ccu","code_information":[{"code":"21000001","type":"CDM"},{"code":"210","type":"RC"}],"standard_charges":[{"gross_charge":8267.0,"discounted_cash":5373.55,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Breast Milk Per Oz Process,Storage,Dist","code_information":[{"code":"22000001","type":"CDM"},{"code":"220","type":"RC"},{"code":"T2101","type":"HCPCS"}],"standard_charges":[{"gross_charge":4.38,"discounted_cash":2.85,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Celestone Per 3 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Mg","code_information":[{"code":"25000016","type":"CDM"},{"code":"636","type":"RC"},{"code":"J3301","type":"HCPCS"}],"standard_charges":[{"gross_charge":39.52,"discounted_cash":25.69,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Synvisc Per Mg","code_information":[{"code":"25000021","type":"CDM"},{"code":"636","type":"RC"},{"code":"J7325","type":"HCPCS"}],"standard_charges":[{"gross_charge":58.24,"discounted_cash":37.86,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Dilapan","code_information":[{"code":"25000031","type":"CDM"},{"code":"272","type":"RC"}],"standard_charges":[{"gross_charge":20.48,"discounted_cash":13.31,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard"}]},{"description":"Hc Inhaled Nitric Oxide Per 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Pharmacy","code_information":[{"code":"25000049_J7050_250","type":"CDM"},{"code":"250","type":"RC"},{"code":"J7050","type":"HCPCS"}],"standard_charges":[{"gross_charge":67.92,"discounted_cash":44.15,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"Noncdm Charge Record Pharmacy","code_information":[{"code":"25000049_J7050_636","type":"CDM"},{"code":"636","type":"RC"},{"code":"J7050","type":"HCPCS"}],"standard_charges":[{"gross_charge":65.69,"discounted_cash":42.7,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Standard | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"Noncdm Charge Record 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