{"hospital_name":"CHI St. Alexius Health Carrington","last_updated_on":"2026-02-28","version":"3.0.0","location_name": ["CHI St. Alexius Health Carrington"],"hospital_address": ["800 North Fourth Street, Carrington, ND 58421"],"license_information":{"license_number":"5008B","state":"ND"},"type_2_npi": ["1205807013","1255445730"],"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":"Jodi Hovdenes , Hospital President"},"standard_charge_information":[{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0011","type":"APR-DRG"}],"standard_charges":[{"minimum":163928,"maximum":163928,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":163928,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0012","type":"APR-DRG"}],"standard_charges":[{"minimum":184633,"maximum":184633,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":184633,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0013","type":"APR-DRG"}],"standard_charges":[{"minimum":220296,"maximum":220296,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":220296,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT","code_information":[{"code":"0014","type":"APR-DRG"}],"standard_charges":[{"minimum":381048,"maximum":381048,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":381048,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0021","type":"APR-DRG"}],"standard_charges":[{"minimum":234501,"maximum":234501,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":234501,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0022","type":"APR-DRG"}],"standard_charges":[{"minimum":273544,"maximum":273544,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":273544,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0023","type":"APR-DRG"}],"standard_charges":[{"minimum":368602,"maximum":368602,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":368602,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEART AND/OR LUNG TRANSPLANT","code_information":[{"code":"0024","type":"APR-DRG"}],"standard_charges":[{"minimum":596076,"maximum":596076,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":596076,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0041","type":"APR-DRG"}],"standard_charges":[{"minimum":121607,"maximum":121607,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":121607,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0042","type":"APR-DRG"}],"standard_charges":[{"minimum":170200,"maximum":170200,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":170200,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0043","type":"APR-DRG"}],"standard_charges":[{"minimum":245388,"maximum":245388,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":245388,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE","code_information":[{"code":"0044","type":"APR-DRG"}],"standard_charges":[{"minimum":370869,"maximum":370869,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":370869,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0051","type":"APR-DRG"}],"standard_charges":[{"minimum":114176,"maximum":114176,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":114176,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0052","type":"APR-DRG"}],"standard_charges":[{"minimum":135432,"maximum":135432,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":135432,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0053","type":"APR-DRG"}],"standard_charges":[{"minimum":233457,"maximum":233457,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":233457,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE","code_information":[{"code":"0054","type":"APR-DRG"}],"standard_charges":[{"minimum":344525,"maximum":344525,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":344525,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MERKEL CELL CARCINOMA","code_information":[{"code":"0058U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":707.29,"maximum":930.13,"gross_charge":968.88,"discounted_cash":561.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":920.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":930.13,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":707.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":804.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":707.29,"methodology":"fee schedule"}]}]},{"description":"MERKEL CELL CARCINOMA","code_information":[{"code":"0058U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":322.96,"maximum":930.13,"gross_charge":968.88,"discounted_cash":561.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":920.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":930.13,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":707.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":804.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":707.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":465.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":329.42,"standard_charge_algorithm": "Lesser of $329.42 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":322.96,"standard_charge_algorithm": "Lesser of $322.96 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0061","type":"APR-DRG"}],"standard_charges":[{"minimum":161459,"maximum":161459,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":161459,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0062","type":"APR-DRG"}],"standard_charges":[{"minimum":205406,"maximum":205406,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":205406,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0063","type":"APR-DRG"}],"standard_charges":[{"minimum":236616,"maximum":236616,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":236616,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PANCREAS TRANSPLANT","code_information":[{"code":"0064","type":"APR-DRG"}],"standard_charges":[{"minimum":336509,"maximum":336509,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":336509,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0071","type":"APR-DRG"}],"standard_charges":[{"minimum":160398,"maximum":160398,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":160398,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0072","type":"APR-DRG"}],"standard_charges":[{"minimum":180140,"maximum":180140,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":180140,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0073","type":"APR-DRG"}],"standard_charges":[{"minimum":224759,"maximum":224759,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":224759,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALLOGENEIC BONE MARROW TRANSPLANT","code_information":[{"code":"0074","type":"APR-DRG"}],"standard_charges":[{"minimum":390776,"maximum":390776,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":390776,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0081","type":"APR-DRG"}],"standard_charges":[{"minimum":78260,"maximum":78260,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":78260,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0082","type":"APR-DRG"}],"standard_charges":[{"minimum":104145,"maximum":104145,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":104145,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0083","type":"APR-DRG"}],"standard_charges":[{"minimum":117294,"maximum":117294,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":117294,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"AUTOLOGOUS BONE MARROW TRANSPLANT OR T-CELL IMMUNOTHERAPY","code_information":[{"code":"0084","type":"APR-DRG"}],"standard_charges":[{"minimum":186805,"maximum":186805,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":186805,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0091","type":"APR-DRG"}],"standard_charges":[{"minimum":104545,"maximum":104545,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":104545,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0092","type":"APR-DRG"}],"standard_charges":[{"minimum":127386,"maximum":127386,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":127386,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0093","type":"APR-DRG"}],"standard_charges":[{"minimum":174655,"maximum":174655,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":174655,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)","code_information":[{"code":"0094","type":"APR-DRG"}],"standard_charges":[{"minimum":332333,"maximum":332333,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":332333,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0201","type":"APR-DRG"}],"standard_charges":[{"minimum":52691,"maximum":52691,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":52691,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0202","type":"APR-DRG"}],"standard_charges":[{"minimum":57372,"maximum":57372,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":57372,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0203","type":"APR-DRG"}],"standard_charges":[{"minimum":82508,"maximum":82508,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":82508,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPEN CRANIOTOMY FOR TRAUMA","code_information":[{"code":"0204","type":"APR-DRG"}],"standard_charges":[{"minimum":129762,"maximum":129762,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":129762,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0211","type":"APR-DRG"}],"standard_charges":[{"minimum":37210,"maximum":37210,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37210,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0212","type":"APR-DRG"}],"standard_charges":[{"minimum":51856,"maximum":51856,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":51856,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0213","type":"APR-DRG"}],"standard_charges":[{"minimum":102211,"maximum":102211,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":102211,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPEN CRANIOTOMY EXCEPT TRAUMA","code_information":[{"code":"0214","type":"APR-DRG"}],"standard_charges":[{"minimum":170592,"maximum":170592,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":170592,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0221","type":"APR-DRG"}],"standard_charges":[{"minimum":33825,"maximum":33825,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33825,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0222","type":"APR-DRG"}],"standard_charges":[{"minimum":38945,"maximum":38945,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38945,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0223","type":"APR-DRG"}],"standard_charges":[{"minimum":53143,"maximum":53143,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":53143,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VENTRICULAR SHUNT PROCEDURES","code_information":[{"code":"0224","type":"APR-DRG"}],"standard_charges":[{"minimum":115329,"maximum":115329,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":115329,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0231","type":"APR-DRG"}],"standard_charges":[{"minimum":29584,"maximum":29584,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29584,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0232","type":"APR-DRG"}],"standard_charges":[{"minimum":53585,"maximum":53585,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":53585,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0233","type":"APR-DRG"}],"standard_charges":[{"minimum":101217,"maximum":101217,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":101217,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPINAL PROCEDURES","code_information":[{"code":"0234","type":"APR-DRG"}],"standard_charges":[{"minimum":152621,"maximum":152621,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":152621,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SARSCOV-2/FLU/RSV (3)","code_information":[{"code":"0240U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":312.44,"maximum":410.88,"gross_charge":428,"discounted_cash":248.24,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":406.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":410.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":312.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":355.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":312.44,"methodology":"fee schedule"}]}]},{"description":"SARSCOV-2/FLU/RSV (3)","code_information":[{"code":"0240U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":142.63,"maximum":410.88,"gross_charge":428,"discounted_cash":248.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":406.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":410.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":312.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":355.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":312.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":205.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":148.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0241","type":"APR-DRG"}],"standard_charges":[{"minimum":20116,"maximum":20116,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20116,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SARSCOV-2/FLU/RSV (4)","code_information":[{"code":"0241U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":116.07,"maximum":152.64,"gross_charge":159,"discounted_cash":92.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":151.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.07,"methodology":"fee schedule"}]}]},{"description":"SARSCOV-2/FLU/RSV (4)","code_information":[{"code":"0241U","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":55.15,"maximum":152.64,"gross_charge":159,"discounted_cash":92.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":151.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":55.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":142.63,"standard_charge_algorithm": "Lesser of $142.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0242","type":"APR-DRG"}],"standard_charges":[{"minimum":24088,"maximum":24088,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24088,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0243","type":"APR-DRG"}],"standard_charges":[{"minimum":49769,"maximum":49769,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":49769,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPEN EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0244","type":"APR-DRG"}],"standard_charges":[{"minimum":100917,"maximum":100917,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":100917,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0261","type":"APR-DRG"}],"standard_charges":[{"minimum":25003,"maximum":25003,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25003,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0262","type":"APR-DRG"}],"standard_charges":[{"minimum":33890,"maximum":33890,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33890,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0263","type":"APR-DRG"}],"standard_charges":[{"minimum":73612,"maximum":73612,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":73612,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER NERVOUS SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"0264","type":"APR-DRG"}],"standard_charges":[{"minimum":103454,"maximum":103454,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":103454,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0271","type":"APR-DRG"}],"standard_charges":[{"minimum":41321,"maximum":41321,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41321,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0272","type":"APR-DRG"}],"standard_charges":[{"minimum":44637,"maximum":44637,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44637,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0273","type":"APR-DRG"}],"standard_charges":[{"minimum":80681,"maximum":80681,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":80681,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER OPEN CRANIOTOMY","code_information":[{"code":"0274","type":"APR-DRG"}],"standard_charges":[{"minimum":128042,"maximum":128042,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":128042,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0291","type":"APR-DRG"}],"standard_charges":[{"minimum":40784,"maximum":40784,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":40784,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0292","type":"APR-DRG"}],"standard_charges":[{"minimum":42823,"maximum":42823,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":42823,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0293","type":"APR-DRG"}],"standard_charges":[{"minimum":57972,"maximum":57972,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":57972,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES","code_information":[{"code":"0294","type":"APR-DRG"}],"standard_charges":[{"minimum":109820,"maximum":109820,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":109820,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0301","type":"APR-DRG"}],"standard_charges":[{"minimum":66157,"maximum":66157,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":66157,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0302","type":"APR-DRG"}],"standard_charges":[{"minimum":71559,"maximum":71559,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":71559,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0303","type":"APR-DRG"}],"standard_charges":[{"minimum":92558,"maximum":92558,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":92558,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES","code_information":[{"code":"0304","type":"APR-DRG"}],"standard_charges":[{"minimum":125888,"maximum":125888,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":125888,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0401","type":"APR-DRG"}],"standard_charges":[{"minimum":21583,"maximum":21583,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21583,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0402","type":"APR-DRG"}],"standard_charges":[{"minimum":61237,"maximum":61237,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":61237,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0403","type":"APR-DRG"}],"standard_charges":[{"minimum":85040,"maximum":85040,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":85040,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPINAL DISORDERS AND INJURIES","code_information":[{"code":"0404","type":"APR-DRG"}],"standard_charges":[{"minimum":137864,"maximum":137864,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":137864,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0411","type":"APR-DRG"}],"standard_charges":[{"minimum":8346,"maximum":8346,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":8346,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0412","type":"APR-DRG"}],"standard_charges":[{"minimum":9303,"maximum":9303,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9303,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0413","type":"APR-DRG"}],"standard_charges":[{"minimum":12290,"maximum":12290,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12290,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NERVOUS SYSTEM MALIGNANCY","code_information":[{"code":"0414","type":"APR-DRG"}],"standard_charges":[{"minimum":18181,"maximum":18181,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18181,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0421","type":"APR-DRG"}],"standard_charges":[{"minimum":21562,"maximum":21562,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21562,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0422","type":"APR-DRG"}],"standard_charges":[{"minimum":34825,"maximum":34825,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34825,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0423","type":"APR-DRG"}],"standard_charges":[{"minimum":36599,"maximum":36599,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36599,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS","code_information":[{"code":"0424","type":"APR-DRG"}],"standard_charges":[{"minimum":50815,"maximum":50815,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50815,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MULTIPLE SCLEROSIS OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0431","type":"APR-DRG"}],"standard_charges":[{"minimum":32743,"maximum":32743,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32743,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MULTIPLE SCLEROSIS OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0432","type":"APR-DRG"}],"standard_charges":[{"minimum":44093,"maximum":44093,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44093,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MULTIPLE SCLEROSIS OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0433","type":"APR-DRG"}],"standard_charges":[{"minimum":51026,"maximum":51026,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":51026,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MULTIPLE SCLEROSIS OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES","code_information":[{"code":"0434","type":"APR-DRG"}],"standard_charges":[{"minimum":75162,"maximum":75162,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":75162,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0441","type":"APR-DRG"}],"standard_charges":[{"minimum":26918,"maximum":26918,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26918,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0442","type":"APR-DRG"}],"standard_charges":[{"minimum":29779,"maximum":29779,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29779,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0443","type":"APR-DRG"}],"standard_charges":[{"minimum":80066,"maximum":80066,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":80066,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTRACRANIAL HEMORRHAGE","code_information":[{"code":"0444","type":"APR-DRG"}],"standard_charges":[{"minimum":89208,"maximum":89208,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":89208,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0451","type":"APR-DRG"}],"standard_charges":[{"minimum":16562,"maximum":16562,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16562,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0452","type":"APR-DRG"}],"standard_charges":[{"minimum":22007,"maximum":22007,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22007,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0453","type":"APR-DRG"}],"standard_charges":[{"minimum":29738,"maximum":29738,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29738,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION","code_information":[{"code":"0454","type":"APR-DRG"}],"standard_charges":[{"minimum":48143,"maximum":48143,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48143,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0461","type":"APR-DRG"}],"standard_charges":[{"minimum":10785,"maximum":10785,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10785,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0462","type":"APR-DRG"}],"standard_charges":[{"minimum":13596,"maximum":13596,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13596,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0463","type":"APR-DRG"}],"standard_charges":[{"minimum":21877,"maximum":21877,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21877,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION","code_information":[{"code":"0464","type":"APR-DRG"}],"standard_charges":[{"minimum":45343,"maximum":45343,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45343,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0471","type":"APR-DRG"}],"standard_charges":[{"minimum":12072,"maximum":12072,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12072,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0472","type":"APR-DRG"}],"standard_charges":[{"minimum":13779,"maximum":13779,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13779,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0473","type":"APR-DRG"}],"standard_charges":[{"minimum":24238,"maximum":24238,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24238,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRANSIENT ISCHEMIA","code_information":[{"code":"0474","type":"APR-DRG"}],"standard_charges":[{"minimum":39430,"maximum":39430,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":39430,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERIPHERAL CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0481","type":"APR-DRG"}],"standard_charges":[{"minimum":12568,"maximum":12568,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12568,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERIPHERAL CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0482","type":"APR-DRG"}],"standard_charges":[{"minimum":14472,"maximum":14472,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14472,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERIPHERAL CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0483","type":"APR-DRG"}],"standard_charges":[{"minimum":19642,"maximum":19642,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19642,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERIPHERAL CRANIAL AND AUTONOMIC NERVE DISORDERS","code_information":[{"code":"0484","type":"APR-DRG"}],"standard_charges":[{"minimum":45621,"maximum":45621,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45621,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0491","type":"APR-DRG"}],"standard_charges":[{"minimum":24131,"maximum":24131,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24131,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0492","type":"APR-DRG"}],"standard_charges":[{"minimum":38099,"maximum":38099,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38099,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0493","type":"APR-DRG"}],"standard_charges":[{"minimum":56433,"maximum":56433,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":56433,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM","code_information":[{"code":"0494","type":"APR-DRG"}],"standard_charges":[{"minimum":97241,"maximum":97241,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":97241,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0501","type":"APR-DRG"}],"standard_charges":[{"minimum":17131,"maximum":17131,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17131,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0502","type":"APR-DRG"}],"standard_charges":[{"minimum":26210,"maximum":26210,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26210,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0503","type":"APR-DRG"}],"standard_charges":[{"minimum":41710,"maximum":41710,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41710,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS","code_information":[{"code":"0504","type":"APR-DRG"}],"standard_charges":[{"minimum":92662,"maximum":92662,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":92662,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0511","type":"APR-DRG"}],"standard_charges":[{"minimum":10737,"maximum":10737,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10737,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0512","type":"APR-DRG"}],"standard_charges":[{"minimum":17822,"maximum":17822,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17822,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0513","type":"APR-DRG"}],"standard_charges":[{"minimum":27927,"maximum":27927,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27927,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VIRAL MENINGITIS","code_information":[{"code":"0514","type":"APR-DRG"}],"standard_charges":[{"minimum":62259,"maximum":62259,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":62259,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0521","type":"APR-DRG"}],"standard_charges":[{"minimum":9740,"maximum":9740,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9740,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0522","type":"APR-DRG"}],"standard_charges":[{"minimum":11529,"maximum":11529,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11529,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0523","type":"APR-DRG"}],"standard_charges":[{"minimum":19101,"maximum":19101,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19101,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALTERATION IN CONSCIOUSNESS","code_information":[{"code":"0524","type":"APR-DRG"}],"standard_charges":[{"minimum":49478,"maximum":49478,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":49478,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SEIZURE","code_information":[{"code":"0531","type":"APR-DRG"}],"standard_charges":[{"minimum":10994,"maximum":10994,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10994,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SEIZURE","code_information":[{"code":"0532","type":"APR-DRG"}],"standard_charges":[{"minimum":14303,"maximum":14303,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14303,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SEIZURE","code_information":[{"code":"0533","type":"APR-DRG"}],"standard_charges":[{"minimum":22294,"maximum":22294,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22294,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SEIZURE","code_information":[{"code":"0534","type":"APR-DRG"}],"standard_charges":[{"minimum":46921,"maximum":46921,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46921,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0541","type":"APR-DRG"}],"standard_charges":[{"minimum":13016,"maximum":13016,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13016,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0542","type":"APR-DRG"}],"standard_charges":[{"minimum":20531,"maximum":20531,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20531,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0543","type":"APR-DRG"}],"standard_charges":[{"minimum":20810,"maximum":20810,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20810,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MIGRAINE AND OTHER HEADACHES","code_information":[{"code":"0544","type":"APR-DRG"}],"standard_charges":[{"minimum":33384,"maximum":33384,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33384,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0551","type":"APR-DRG"}],"standard_charges":[{"minimum":9068,"maximum":9068,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9068,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0552","type":"APR-DRG"}],"standard_charges":[{"minimum":25801,"maximum":25801,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25801,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0553","type":"APR-DRG"}],"standard_charges":[{"minimum":38667,"maximum":38667,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38667,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE","code_information":[{"code":"0554","type":"APR-DRG"}],"standard_charges":[{"minimum":69155,"maximum":69155,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":69155,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0561","type":"APR-DRG"}],"standard_charges":[{"minimum":15405,"maximum":15405,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15405,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0562","type":"APR-DRG"}],"standard_charges":[{"minimum":18683,"maximum":18683,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18683,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0563","type":"APR-DRG"}],"standard_charges":[{"minimum":29475,"maximum":29475,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29475,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BRAIN CONTUSION OR LACERATION AND COMPLICATED SKULL FRACTURE COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0564","type":"APR-DRG"}],"standard_charges":[{"minimum":48491,"maximum":48491,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48491,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CONCUSSION CLOSED SKULL FRACTURE NOS AND UNCOMPLICATED INTRACRANIAL INJURY COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0571","type":"APR-DRG"}],"standard_charges":[{"minimum":11120,"maximum":11120,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11120,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CONCUSSION CLOSED SKULL FRACTURE NOS AND UNCOMPLICATED INTRACRANIAL INJURY COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0572","type":"APR-DRG"}],"standard_charges":[{"minimum":13103,"maximum":13103,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13103,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CONCUSSION CLOSED SKULL FRACTURE NOS AND UNCOMPLICATED INTRACRANIAL INJURY COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0573","type":"APR-DRG"}],"standard_charges":[{"minimum":33149,"maximum":33149,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33149,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CONCUSSION CLOSED SKULL FRACTURE NOS AND UNCOMPLICATED INTRACRANIAL INJURY COMA < 1 HOUR OR NO COMA","code_information":[{"code":"0574","type":"APR-DRG"}],"standard_charges":[{"minimum":50124,"maximum":50124,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50124,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0581","type":"APR-DRG"}],"standard_charges":[{"minimum":19338,"maximum":19338,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19338,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0582","type":"APR-DRG"}],"standard_charges":[{"minimum":20786,"maximum":20786,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20786,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0583","type":"APR-DRG"}],"standard_charges":[{"minimum":23925,"maximum":23925,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23925,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DISORDERS OF NERVOUS SYSTEM","code_information":[{"code":"0584","type":"APR-DRG"}],"standard_charges":[{"minimum":34982,"maximum":34982,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34982,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0591","type":"APR-DRG"}],"standard_charges":[{"minimum":13427,"maximum":13427,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13427,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0592","type":"APR-DRG"}],"standard_charges":[{"minimum":20655,"maximum":20655,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20655,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0593","type":"APR-DRG"}],"standard_charges":[{"minimum":34277,"maximum":34277,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34277,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANOXIC AND OTHER SEVERE BRAIN DAMAGE","code_information":[{"code":"0594","type":"APR-DRG"}],"standard_charges":[{"minimum":43054,"maximum":43054,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43054,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0731","type":"APR-DRG"}],"standard_charges":[{"minimum":20825,"maximum":20825,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20825,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0732","type":"APR-DRG"}],"standard_charges":[{"minimum":28399,"maximum":28399,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28399,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0733","type":"APR-DRG"}],"standard_charges":[{"minimum":46567,"maximum":46567,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46567,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ORBIT AND EYE PROCEDURES","code_information":[{"code":"0734","type":"APR-DRG"}],"standard_charges":[{"minimum":89821,"maximum":89821,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":89821,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0821","type":"APR-DRG"}],"standard_charges":[{"minimum":11227,"maximum":11227,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11227,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0822","type":"APR-DRG"}],"standard_charges":[{"minimum":13794,"maximum":13794,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13794,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0823","type":"APR-DRG"}],"standard_charges":[{"minimum":20568,"maximum":20568,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20568,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EYE INFECTIONS AND OTHER EYE DISORDERS","code_information":[{"code":"0824","type":"APR-DRG"}],"standard_charges":[{"minimum":45769,"maximum":45769,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45769,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0891","type":"APR-DRG"}],"standard_charges":[{"minimum":36171,"maximum":36171,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36171,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0892","type":"APR-DRG"}],"standard_charges":[{"minimum":45832,"maximum":45832,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45832,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0893","type":"APR-DRG"}],"standard_charges":[{"minimum":110487,"maximum":110487,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":110487,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0894","type":"APR-DRG"}],"standard_charges":[{"minimum":135888,"maximum":135888,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":135888,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0911","type":"APR-DRG"}],"standard_charges":[{"minimum":43465,"maximum":43465,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43465,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0912","type":"APR-DRG"}],"standard_charges":[{"minimum":52211,"maximum":52211,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":52211,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0913","type":"APR-DRG"}],"standard_charges":[{"minimum":101945,"maximum":101945,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":101945,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MAJOR HEAD AND NECK PROCEDURES","code_information":[{"code":"0914","type":"APR-DRG"}],"standard_charges":[{"minimum":159722,"maximum":159722,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":159722,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0921","type":"APR-DRG"}],"standard_charges":[{"minimum":28814,"maximum":28814,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28814,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0922","type":"APR-DRG"}],"standard_charges":[{"minimum":37569,"maximum":37569,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37569,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0923","type":"APR-DRG"}],"standard_charges":[{"minimum":70090,"maximum":70090,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":70090,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES","code_information":[{"code":"0924","type":"APR-DRG"}],"standard_charges":[{"minimum":109289,"maximum":109289,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":109289,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0951","type":"APR-DRG"}],"standard_charges":[{"minimum":19903,"maximum":19903,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19903,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0952","type":"APR-DRG"}],"standard_charges":[{"minimum":24025,"maximum":24025,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24025,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0953","type":"APR-DRG"}],"standard_charges":[{"minimum":38823,"maximum":38823,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38823,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CLEFT LIP AND PALATE REPAIR","code_information":[{"code":"0954","type":"APR-DRG"}],"standard_charges":[{"minimum":55424,"maximum":55424,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":55424,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0971","type":"APR-DRG"}],"standard_charges":[{"minimum":12511,"maximum":12511,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12511,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0972","type":"APR-DRG"}],"standard_charges":[{"minimum":21851,"maximum":21851,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21851,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0973","type":"APR-DRG"}],"standard_charges":[{"minimum":30090,"maximum":30090,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30090,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TONSIL AND ADENOID PROCEDURES","code_information":[{"code":"0974","type":"APR-DRG"}],"standard_charges":[{"minimum":69116,"maximum":69116,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":69116,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER EAR NOSE MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0981","type":"APR-DRG"}],"standard_charges":[{"minimum":12100,"maximum":12100,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12100,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER EAR NOSE MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0982","type":"APR-DRG"}],"standard_charges":[{"minimum":29329,"maximum":29329,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29329,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER EAR NOSE MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0983","type":"APR-DRG"}],"standard_charges":[{"minimum":55350,"maximum":55350,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":55350,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER EAR NOSE MOUTH AND THROAT PROCEDURES","code_information":[{"code":"0984","type":"APR-DRG"}],"standard_charges":[{"minimum":88143,"maximum":88143,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":88143,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SUT VCRL 0 54IN VIOL","code_information":[{"code":"100023","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":6.57,"maximum":8.64,"gross_charge":9,"discounted_cash":5.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6.57,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL 0 54IN VIOL","code_information":[{"code":"100023","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2.88,"maximum":8.64,"gross_charge":9,"discounted_cash":5.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.88,"methodology":"fee schedule"}]}]},{"description":"CATH KT URETH INTMIT FEM 8FR","code_information":[{"code":"100133","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":7.3,"maximum":9.6,"gross_charge":10,"discounted_cash":5.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":9.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":9.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7.3,"methodology":"fee schedule"}]}]},{"description":"CATH KT URETH INTMIT FEM 8FR","code_information":[{"code":"100133","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":3.2,"maximum":9.6,"gross_charge":10,"discounted_cash":5.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":9.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":9.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3.2,"methodology":"fee schedule"}]}]},{"description":"DRSNG TRIANG COMBIDERM ACD 6X7","code_information":[{"code":"100175","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":17.52,"maximum":23.04,"gross_charge":24,"discounted_cash":13.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":22.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":23.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":17.52,"methodology":"fee schedule"}]}]},{"description":"DRSNG TRIANG COMBIDERM ACD 6X7","code_information":[{"code":"100175","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":7.68,"maximum":23.04,"gross_charge":24,"discounted_cash":13.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":22.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":23.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":17.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":11.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":8.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.68,"methodology":"fee schedule"}]}]},{"description":"CATH KT ENTRL PATROL PMP 1000","code_information":[{"code":"100787","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":8.03,"maximum":10.56,"gross_charge":11,"discounted_cash":6.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":10.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":10.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8.03,"methodology":"fee schedule"}]}]},{"description":"CATH KT ENTRL PATROL PMP 1000","code_information":[{"code":"100787","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":3.52,"maximum":10.56,"gross_charge":11,"discounted_cash":6.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":10.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":10.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3.52,"methodology":"fee schedule"}]}]},{"description":"NDL BX SFT STD NSAF 14GX4.5IN","code_information":[{"code":"100913","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":45.26,"maximum":59.52,"gross_charge":62,"discounted_cash":35.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":58.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":59.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":45.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":45.26,"methodology":"fee schedule"}]}]},{"description":"NDL BX SFT STD NSAF 14GX4.5IN","code_information":[{"code":"100913","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":19.84,"maximum":59.52,"gross_charge":62,"discounted_cash":35.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":58.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":59.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":45.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":45.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":29.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":21.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":19.84,"methodology":"fee schedule"}]}]},{"description":"APPLIER LIG MCA SM 9 3/8IN","code_information":[{"code":"101192","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":127.02,"maximum":167.04,"gross_charge":174,"discounted_cash":100.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":165.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":167.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":127.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":144.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":127.02,"methodology":"fee schedule"}]}]},{"description":"APPLIER LIG MCA SM 9 3/8IN","code_information":[{"code":"101192","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":55.68,"maximum":167.04,"gross_charge":174,"discounted_cash":100.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":165.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":167.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":127.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":144.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":127.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":83.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":60.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":55.68,"methodology":"fee schedule"}]}]},{"description":"STOCKING ANTIEMB TH 16MM LG RG","code_information":[{"code":"101303","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":22.63,"maximum":29.76,"gross_charge":31,"discounted_cash":17.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":29.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":29.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":22.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":22.63,"methodology":"fee schedule"}]}]},{"description":"STOCKING ANTIEMB TH 16MM LG RG","code_information":[{"code":"101303","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":9.92,"maximum":29.76,"gross_charge":31,"discounted_cash":17.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":29.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":29.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":22.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":22.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":14.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.92,"methodology":"fee schedule"}]}]},{"description":"TAP 180 HEX DC SCR 5.2MM","code_information":[{"code":"101385","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":568.67,"maximum":747.84,"gross_charge":779,"discounted_cash":451.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":740.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":747.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":568.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":646.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":568.67,"methodology":"fee schedule"}]}]},{"description":"TAP 180 HEX DC SCR 5.2MM","code_information":[{"code":"101385","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":249.28,"maximum":747.84,"gross_charge":779,"discounted_cash":451.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":740.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":747.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":568.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":646.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":568.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":373.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":270.16,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":249.28,"methodology":"fee schedule"}]}]},{"description":"SUT POLYSRB 0 36IN GS24 VIOL","code_information":[{"code":"101441","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":5.84,"maximum":7.68,"gross_charge":8,"discounted_cash":4.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.84,"methodology":"fee schedule"}]}]},{"description":"SUT POLYSRB 0 36IN GS24 VIOL","code_information":[{"code":"101441","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2.56,"maximum":7.68,"gross_charge":8,"discounted_cash":4.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.56,"methodology":"fee schedule"}]}]},{"description":"CATH ENTRL BOL STYL 12FRX45IN","code_information":[{"code":"101456","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":73,"maximum":96,"gross_charge":100,"discounted_cash":58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":73,"methodology":"fee schedule"}]}]},{"description":"CATH ENTRL BOL STYL 12FRX45IN","code_information":[{"code":"101456","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":32,"maximum":96,"gross_charge":100,"discounted_cash":58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":34.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":32,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL GASTROVIEW 240ML BTL","code_information":[{"code":"101612","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":105.95,"maximum":139.33,"gross_charge":145.13,"discounted_cash":84.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":137.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":139.33,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":105.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":120.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":105.95,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL GASTROVIEW 240ML BTL","code_information":[{"code":"101612","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":46.45,"maximum":139.33,"gross_charge":145.13,"discounted_cash":84.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":137.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":139.33,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":105.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":120.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":105.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":69.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":50.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":46.45,"methodology":"fee schedule"}]}]},{"description":"PROC TY THORCENT NDL 16GX3.5IN","code_information":[{"code":"101861","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":54.02,"maximum":71.04,"gross_charge":74,"discounted_cash":42.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":70.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":54.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":61.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":54.02,"methodology":"fee schedule"}]}]},{"description":"PROC TY THORCENT NDL 16GX3.5IN","code_information":[{"code":"101861","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":23.68,"maximum":71.04,"gross_charge":74,"discounted_cash":42.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":70.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":54.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":61.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":54.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":35.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":25.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":23.68,"methodology":"fee schedule"}]}]},{"description":"DRAIN T TB DEAVER 5IN XBAR 18","code_information":[{"code":"102579","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":22.63,"maximum":29.76,"gross_charge":31,"discounted_cash":17.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":29.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":29.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":22.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":22.63,"methodology":"fee schedule"}]}]},{"description":"DRAIN T TB DEAVER 5IN XBAR 18","code_information":[{"code":"102579","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":9.92,"maximum":29.76,"gross_charge":31,"discounted_cash":17.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":29.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":29.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":22.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":22.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":14.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.92,"methodology":"fee schedule"}]}]},{"description":"CLAMP PCH OST QUIET FLM LF BGE","code_information":[{"code":"102754","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":3.65,"maximum":4.8,"gross_charge":5,"discounted_cash":2.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3.65,"methodology":"fee schedule"}]}]},{"description":"CLAMP PCH OST QUIET FLM LF BGE","code_information":[{"code":"102754","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1.6,"maximum":4.8,"gross_charge":5,"discounted_cash":2.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1.6,"methodology":"fee schedule"}]}]},{"description":"DRSNG OIL EMUL 3X16IN","code_information":[{"code":"102897","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":78.84,"maximum":103.68,"gross_charge":108,"discounted_cash":62.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":102.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":103.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":78.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":89.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":78.84,"methodology":"fee schedule"}]}]},{"description":"DRSNG OIL EMUL 3X16IN","code_information":[{"code":"102897","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":34.56,"maximum":103.68,"gross_charge":108,"discounted_cash":62.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":102.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":103.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":78.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":89.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":78.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":37.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":34.56,"methodology":"fee schedule"}]}]},{"description":"KT THORACENT SHRP SAF 8FRX7.5","code_information":[{"code":"103079","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":159.87,"maximum":210.24,"gross_charge":219,"discounted_cash":127.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":208.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":210.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":159.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":159.87,"methodology":"fee schedule"}]}]},{"description":"KT THORACENT SHRP SAF 8FRX7.5","code_information":[{"code":"103079","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":70.08,"maximum":210.24,"gross_charge":219,"discounted_cash":127.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":208.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":210.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":159.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":159.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":105.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":75.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":70.08,"methodology":"fee schedule"}]}]},{"description":"CATH FOL BARDX MED 24FRX30ML","code_information":[{"code":"103296","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":14.6,"maximum":19.2,"gross_charge":20,"discounted_cash":11.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":14.6,"methodology":"fee schedule"}]}]},{"description":"CATH FOL BARDX MED 24FRX30ML","code_information":[{"code":"103296","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":6.4,"maximum":19.2,"gross_charge":20,"discounted_cash":11.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":14.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":9.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":6.4,"methodology":"fee schedule"}]}]},{"description":"SOL NACL 0.9PCT 50ML ADD-V BG","code_information":[{"code":"103606","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":4.91,"maximum":6.46,"gross_charge":6.72,"discounted_cash":3.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6.46,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4.91,"methodology":"fee schedule"}]}]},{"description":"SOL NACL 0.9PCT 50ML ADD-V BG","code_information":[{"code":"103606","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":2.16,"maximum":6.46,"gross_charge":6.72,"discounted_cash":3.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6.46,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.16,"methodology":"fee schedule"}]}]},{"description":"DEVICE TRCR SITE ENDO CLOSE","code_information":[{"code":"103663","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":164.25,"maximum":216,"gross_charge":225,"discounted_cash":130.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":213.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":216,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":164.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":186.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":164.25,"methodology":"fee schedule"}]}]},{"description":"DEVICE TRCR SITE ENDO CLOSE","code_information":[{"code":"103663","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":72,"maximum":216,"gross_charge":225,"discounted_cash":130.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":213.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":216,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":164.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":186.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":164.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72,"methodology":"fee schedule"}]}]},{"description":"CATH FOL BARDX 12FRX5ML SIL.","code_information":[{"code":"103676","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":13.87,"maximum":18.24,"gross_charge":19,"discounted_cash":11.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":18.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":18.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.87,"methodology":"fee schedule"}]}]},{"description":"CATH FOL BARDX 12FRX5ML SIL.","code_information":[{"code":"103676","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":6.08,"maximum":18.24,"gross_charge":19,"discounted_cash":11.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":18.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":18.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":9.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":6.08,"methodology":"fee schedule"}]}]},{"description":"BIT DRL TWST AO 1.9X87X27MM SS","code_information":[{"code":"103810","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":189.07,"maximum":248.64,"gross_charge":259,"discounted_cash":150.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":246.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":248.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":189.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":214.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":189.07,"methodology":"fee schedule"}]}]},{"description":"BIT DRL TWST AO 1.9X87X27MM SS","code_information":[{"code":"103810","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":82.88,"maximum":248.64,"gross_charge":259,"discounted_cash":150.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":246.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":248.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":189.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":214.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":189.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":124.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":89.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":82.88,"methodology":"fee schedule"}]}]},{"description":"BAG DRNGE URIN MONO-FLO 2000ML","code_information":[{"code":"103985","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":18.98,"maximum":24.96,"gross_charge":26,"discounted_cash":15.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":24.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":24.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":18.98,"methodology":"fee schedule"}]}]},{"description":"BAG DRNGE URIN MONO-FLO 2000ML","code_information":[{"code":"103985","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":8.32,"maximum":24.96,"gross_charge":26,"discounted_cash":15.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":24.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":24.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":18.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.32,"methodology":"fee schedule"}]}]},{"description":"POUCH DRN 1PC TAPE OPN TO2.5IN","code_information":[{"code":"104016","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":5.84,"maximum":7.68,"gross_charge":8,"discounted_cash":4.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.84,"methodology":"fee schedule"}]}]},{"description":"POUCH DRN 1PC TAPE OPN TO2.5IN","code_information":[{"code":"104016","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":2.56,"maximum":7.68,"gross_charge":8,"discounted_cash":4.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.56,"methodology":"fee schedule"}]}]},{"description":"BALL ELECTRODE 5MMDIA 13CM LNG","code_information":[{"code":"104425","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":43.8,"maximum":57.6,"gross_charge":60,"discounted_cash":34.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":57.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":43.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":49.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":43.8,"methodology":"fee schedule"}]}]},{"description":"BALL ELECTRODE 5MMDIA 13CM LNG","code_information":[{"code":"104425","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":19.2,"maximum":57.6,"gross_charge":60,"discounted_cash":34.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":57.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":43.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":49.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":43.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":28.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":20.81,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"}]}]},{"description":"CURETTE UTER VAC CRV BERK 12MM","code_information":[{"code":"104429","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":16.79,"maximum":22.08,"gross_charge":23,"discounted_cash":13.34,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":21.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.79,"methodology":"fee schedule"}]}]},{"description":"CURETTE UTER VAC CRV BERK 12MM","code_information":[{"code":"104429","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":7.36,"maximum":22.08,"gross_charge":23,"discounted_cash":13.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":21.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":11.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.36,"methodology":"fee schedule"}]}]},{"description":"CATH GASTSTMY MAGNA-PRT 18FR","code_information":[{"code":"104443","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":69.35,"maximum":91.2,"gross_charge":95,"discounted_cash":55.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":90.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":91.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":69.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":78.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":69.35,"methodology":"fee schedule"}]}]},{"description":"CATH GASTSTMY MAGNA-PRT 18FR","code_information":[{"code":"104443","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":30.4,"maximum":91.2,"gross_charge":95,"discounted_cash":55.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":90.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":91.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":69.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":78.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":69.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":45.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":30.4,"methodology":"fee schedule"}]}]},{"description":"DRSNG ALLEVYN 3X3IN LF STRL","code_information":[{"code":"104478","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":11.68,"maximum":15.36,"gross_charge":16,"discounted_cash":9.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":15.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":15.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":11.68,"methodology":"fee schedule"}]}]},{"description":"DRSNG ALLEVYN 3X3IN LF STRL","code_information":[{"code":"104478","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":5.12,"maximum":15.36,"gross_charge":16,"discounted_cash":9.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":15.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":15.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":11.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":7.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":5.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.12,"methodology":"fee schedule"}]}]},{"description":"RELOAD STPLR LIN CUT 45-3.5MM","code_information":[{"code":"105194","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":268.64,"maximum":353.28,"gross_charge":368,"discounted_cash":213.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":349.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":353.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":268.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":305.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":268.64,"methodology":"fee schedule"}]}]},{"description":"RELOAD STPLR LIN CUT 45-3.5MM","code_information":[{"code":"105194","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":117.76,"maximum":353.28,"gross_charge":368,"discounted_cash":213.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":349.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":353.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":268.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":305.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":268.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":127.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":117.76,"methodology":"fee schedule"}]}]},{"description":"NUT USS 12PT 11MM TI NS","code_information":[{"code":"105462","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":270.83,"maximum":356.16,"gross_charge":371,"discounted_cash":215.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":352.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":356.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":270.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":307.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":270.83,"methodology":"fee schedule"}]}]},{"description":"NUT USS 12PT 11MM TI NS","code_information":[{"code":"105462","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":118.72,"maximum":356.16,"gross_charge":371,"discounted_cash":215.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":352.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":356.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":270.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":307.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":270.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":178.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":128.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":118.72,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL 0 18IN MP VIOL","code_information":[{"code":"105807","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":33.58,"maximum":44.16,"gross_charge":46,"discounted_cash":26.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":43.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":44.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":33.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":38.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":33.58,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL 0 18IN MP VIOL","code_information":[{"code":"105807","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":14.72,"maximum":44.16,"gross_charge":46,"discounted_cash":26.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":43.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":44.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":33.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":38.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":33.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":15.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":14.72,"methodology":"fee schedule"}]}]},{"description":"DRSNG TEGADERM 4X5.5IN TRNSPAR","code_information":[{"code":"105999","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":2.19,"maximum":2.88,"gross_charge":3,"discounted_cash":1.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.19,"methodology":"fee schedule"}]}]},{"description":"DRSNG TEGADERM 4X5.5IN TRNSPAR","code_information":[{"code":"105999","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":0.96,"maximum":2.88,"gross_charge":3,"discounted_cash":1.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.96,"methodology":"fee schedule"}]}]},{"description":"NDL INTOSS IL 4.7 LANC PT 15G","code_information":[{"code":"106564","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":29.93,"maximum":39.36,"gross_charge":41,"discounted_cash":23.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.93,"methodology":"fee schedule"}]}]},{"description":"NDL INTOSS IL 4.7 LANC PT 15G","code_information":[{"code":"106564","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":13.12,"maximum":39.36,"gross_charge":41,"discounted_cash":23.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.12,"methodology":"fee schedule"}]}]},{"description":"PORT KT SL MRI X-PRT 8FR PLAS","code_information":[{"code":"106707","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":586.92,"maximum":771.84,"gross_charge":804,"discounted_cash":466.32,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":763.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":771.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":586.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":667.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":586.92,"methodology":"fee schedule"}]}]},{"description":"PORT KT SL MRI X-PRT 8FR PLAS","code_information":[{"code":"106707","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":257.28,"maximum":771.84,"gross_charge":804,"discounted_cash":466.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":763.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":771.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":586.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":667.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":586.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":385.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":278.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":257.28,"methodology":"fee schedule"}]}]},{"description":"SOL D5 NACL 0.9PCT KCL 20 1L","code_information":[{"code":"106774","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":6.05,"maximum":7.95,"gross_charge":8.28,"discounted_cash":4.81,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7.95,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6.05,"methodology":"fee schedule"}]}]},{"description":"SOL D5 NACL 0.9PCT KCL 20 1L","code_information":[{"code":"106774","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":2.65,"maximum":7.95,"gross_charge":8.28,"discounted_cash":4.81,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7.95,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6.05,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.65,"methodology":"fee schedule"}]}]},{"description":"NDL PRT Y SITE SAF 19GX1IN","code_information":[{"code":"107050","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":243.82,"maximum":320.64,"gross_charge":334,"discounted_cash":193.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":317.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":320.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":277.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.82,"methodology":"fee schedule"}]}]},{"description":"NDL PRT Y SITE SAF 19GX1IN","code_information":[{"code":"107050","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":106.88,"maximum":320.64,"gross_charge":334,"discounted_cash":193.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":317.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":320.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":277.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":115.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":106.88,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC STP-45 3.0X190 NS","code_information":[{"code":"107305","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":373.03,"maximum":490.56,"gross_charge":511,"discounted_cash":296.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":485.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":490.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":373.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":424.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":373.03,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC STP-45 3.0X190 NS","code_information":[{"code":"107305","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":163.52,"maximum":490.56,"gross_charge":511,"discounted_cash":296.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":485.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":490.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":373.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":424.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":373.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":245.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":177.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":163.52,"methodology":"fee schedule"}]}]},{"description":"TAP CAL-50 SCR CANC 3.5MM NS","code_information":[{"code":"107372","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":376.68,"maximum":495.36,"gross_charge":516,"discounted_cash":299.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":490.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":495.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":428.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":376.68,"methodology":"fee schedule"}]}]},{"description":"TAP CAL-50 SCR CANC 3.5MM NS","code_information":[{"code":"107372","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":165.12,"maximum":495.36,"gross_charge":516,"discounted_cash":299.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":490.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":495.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":428.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":247.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":178.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":165.12,"methodology":"fee schedule"}]}]},{"description":"HOOK PRC TRNVRS OP L TI NS","code_information":[{"code":"107384","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1071.64,"maximum":1409.28,"gross_charge":1468,"discounted_cash":851.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1394.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1409.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1071.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1218.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1071.64,"methodology":"fee schedule"}]}]},{"description":"HOOK PRC TRNVRS OP L TI NS","code_information":[{"code":"107384","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":469.76,"maximum":1409.28,"gross_charge":1468,"discounted_cash":851.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1394.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1409.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1071.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1218.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1071.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":704.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":509.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":469.76,"methodology":"fee schedule"}]}]},{"description":"STOCKING ANTIEMB TH 16MM LG LN","code_information":[{"code":"107491","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":18.98,"maximum":24.96,"gross_charge":26,"discounted_cash":15.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":24.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":24.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":18.98,"methodology":"fee schedule"}]}]},{"description":"STOCKING ANTIEMB TH 16MM LG LN","code_information":[{"code":"107491","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":8.32,"maximum":24.96,"gross_charge":26,"discounted_cash":15.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":24.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":24.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":18.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.32,"methodology":"fee schedule"}]}]},{"description":"DRAIN WND PENROSE 0.5X12IN","code_information":[{"code":"107633","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1.46,"maximum":1.92,"gross_charge":2,"discounted_cash":1.16,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1.46,"methodology":"fee schedule"}]}]},{"description":"DRAIN WND PENROSE 0.5X12IN","code_information":[{"code":"107633","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":0.64,"maximum":1.92,"gross_charge":2,"discounted_cash":1.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":0.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":0.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.64,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL 5-0 18IN P3 UD","code_information":[{"code":"107878","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":15.33,"maximum":20.16,"gross_charge":21,"discounted_cash":12.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":19.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":20.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":15.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":15.33,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL 5-0 18IN P3 UD","code_information":[{"code":"107878","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":6.72,"maximum":20.16,"gross_charge":21,"discounted_cash":12.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":19.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":20.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":15.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":15.33,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":10.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"}]}]},{"description":"CATH JEJUSTMY BAKER 16FRX15ML","code_information":[{"code":"108099","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":132.86,"maximum":174.72,"gross_charge":182,"discounted_cash":105.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":172.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":174.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":132.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":151.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":132.86,"methodology":"fee schedule"}]}]},{"description":"CATH JEJUSTMY BAKER 16FRX15ML","code_information":[{"code":"108099","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":58.24,"maximum":174.72,"gross_charge":182,"discounted_cash":105.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":172.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":174.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":132.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":151.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":132.86,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":87.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":63.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":58.24,"methodology":"fee schedule"}]}]},{"description":"SUT ETHLN 3-0 18IN PS1 BLK","code_information":[{"code":"108354","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":12.41,"maximum":16.32,"gross_charge":17,"discounted_cash":9.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":16.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":16.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":12.41,"methodology":"fee schedule"}]}]},{"description":"SUT ETHLN 3-0 18IN PS1 BLK","code_information":[{"code":"108354","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":5.44,"maximum":16.32,"gross_charge":17,"discounted_cash":9.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":16.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":16.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":12.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":8.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":5.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.44,"methodology":"fee schedule"}]}]},{"description":"SPLNT FNGR GUTTER LG 5.5X7/8","code_information":[{"code":"108453","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":4.38,"maximum":5.76,"gross_charge":6,"discounted_cash":3.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4.38,"methodology":"fee schedule"}]}]},{"description":"SPLNT FNGR GUTTER LG 5.5X7/8","code_information":[{"code":"108453","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1.92,"maximum":5.76,"gross_charge":6,"discounted_cash":3.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1.92,"methodology":"fee schedule"}]}]},{"description":"SUT PROL 5-0 18IN PS3 BLU","code_information":[{"code":"108549","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":16.06,"maximum":21.12,"gross_charge":22,"discounted_cash":12.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":20.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":21.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.06,"methodology":"fee schedule"}]}]},{"description":"SUT PROL 5-0 18IN PS3 BLU","code_information":[{"code":"108549","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":7.04,"maximum":21.12,"gross_charge":22,"discounted_cash":12.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":20.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":21.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":10.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.04,"methodology":"fee schedule"}]}]},{"description":"PLUG CATH CAP LG","code_information":[{"code":"108629","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2.19,"maximum":2.88,"gross_charge":3,"discounted_cash":1.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.19,"methodology":"fee schedule"}]}]},{"description":"PLUG CATH CAP LG","code_information":[{"code":"108629","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":0.96,"maximum":2.88,"gross_charge":3,"discounted_cash":1.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.96,"methodology":"fee schedule"}]}]},{"description":"SPNG SURGCEL 2X14IN LF STRL","code_information":[{"code":"108745","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":191.26,"maximum":251.52,"gross_charge":262,"discounted_cash":151.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":248.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":251.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":191.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":217.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":191.26,"methodology":"fee schedule"}]}]},{"description":"SPNG SURGCEL 2X14IN LF STRL","code_information":[{"code":"108745","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":83.84,"maximum":251.52,"gross_charge":262,"discounted_cash":151.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":248.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":251.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":191.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":217.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":191.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":125.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":90.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":83.84,"methodology":"fee schedule"}]}]},{"description":"CATH CV DL 2VC GROSH 9.5FR","code_information":[{"code":"109414","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1256.33,"maximum":1652.16,"gross_charge":1721,"discounted_cash":998.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1634.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1652.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1256.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1428.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1256.33,"methodology":"fee schedule"}]}]},{"description":"CATH CV DL 2VC GROSH 9.5FR","code_information":[{"code":"109414","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":550.72,"maximum":1652.16,"gross_charge":1721,"discounted_cash":998.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1634.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1652.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1256.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1428.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1256.33,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":826.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":596.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":550.72,"methodology":"fee schedule"}]}]},{"description":"CATH FOL COUDE TIEM 22FRX5ML","code_information":[{"code":"109489","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":31.39,"maximum":41.28,"gross_charge":43,"discounted_cash":24.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":40.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":41.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":31.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":35.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":31.39,"methodology":"fee schedule"}]}]},{"description":"CATH FOL COUDE TIEM 22FRX5ML","code_information":[{"code":"109489","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":13.76,"maximum":41.28,"gross_charge":43,"discounted_cash":24.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":40.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":41.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":31.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":35.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":31.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":20.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.76,"methodology":"fee schedule"}]}]},{"description":"ADHESIVE DERMABOND 2 OCTYLPK1/","code_information":[{"code":"109495","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":50.37,"maximum":66.24,"gross_charge":69,"discounted_cash":40.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":65.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":66.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":50.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":57.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":50.37,"methodology":"fee schedule"}]}]},{"description":"ADHESIVE DERMABOND 2 OCTYLPK1/","code_information":[{"code":"109495","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":22.08,"maximum":66.24,"gross_charge":69,"discounted_cash":40.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":65.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":66.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":50.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":57.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":50.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":33.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":23.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"}]}]},{"description":"COAGULATOR SUC HND 10FR 6IN","code_information":[{"code":"109621","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":19.71,"maximum":25.92,"gross_charge":27,"discounted_cash":15.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.71,"methodology":"fee schedule"}]}]},{"description":"COAGULATOR SUC HND 10FR 6IN","code_information":[{"code":"109621","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":8.64,"maximum":25.92,"gross_charge":27,"discounted_cash":15.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"}]}]},{"description":"SUT SOFSILK 1 30IN V26 BLK","code_information":[{"code":"109946","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":5.11,"maximum":6.72,"gross_charge":7,"discounted_cash":4.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.11,"methodology":"fee schedule"}]}]},{"description":"SUT SOFSILK 1 30IN V26 BLK","code_information":[{"code":"109946","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2.24,"maximum":6.72,"gross_charge":7,"discounted_cash":4.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.24,"methodology":"fee schedule"}]}]},{"description":"STAPLER INT MULT TA 90-3.5MM","code_information":[{"code":"109959","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":227.03,"maximum":298.56,"gross_charge":311,"discounted_cash":180.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":295.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":298.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":227.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":258.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":227.03,"methodology":"fee schedule"}]}]},{"description":"STAPLER INT MULT TA 90-3.5MM","code_information":[{"code":"109959","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":99.52,"maximum":298.56,"gross_charge":311,"discounted_cash":180.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":295.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":298.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":227.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":258.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":227.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":149.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":107.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":99.52,"methodology":"fee schedule"}]}]},{"description":"EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1101","type":"APR-DRG"}],"standard_charges":[{"minimum":17409,"maximum":17409,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17409,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BLDE SHV SYNOVATR CRV 4.5X17MM","code_information":[{"code":"110185","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":170.82,"maximum":224.64,"gross_charge":234,"discounted_cash":135.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":222.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":224.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":170.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":194.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":170.82,"methodology":"fee schedule"}]}]},{"description":"BLDE SHV SYNOVATR CRV 4.5X17MM","code_information":[{"code":"110185","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":74.88,"maximum":224.64,"gross_charge":234,"discounted_cash":135.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":222.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":224.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":170.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":194.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":170.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":112.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":81.16,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":74.88,"methodology":"fee schedule"}]}]},{"description":"EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1102","type":"APR-DRG"}],"standard_charges":[{"minimum":20864,"maximum":20864,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20864,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SUT VCRL 3-0 27IN FS1 UD","code_information":[{"code":"110237","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":8.76,"maximum":11.52,"gross_charge":12,"discounted_cash":6.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8.76,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL 3-0 27IN FS1 UD","code_information":[{"code":"110237","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":3.84,"maximum":11.52,"gross_charge":12,"discounted_cash":6.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":4.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3.84,"methodology":"fee schedule"}]}]},{"description":"EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1103","type":"APR-DRG"}],"standard_charges":[{"minimum":30090,"maximum":30090,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30090,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL MALIGNANCIES","code_information":[{"code":"1104","type":"APR-DRG"}],"standard_charges":[{"minimum":49213,"maximum":49213,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":49213,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PIN FX TEMP CERV LCK PLT NS","code_information":[{"code":"110897","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":285.43,"maximum":375.36,"gross_charge":391,"discounted_cash":226.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":371.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":375.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":285.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":324.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":285.43,"methodology":"fee schedule"}]}]},{"description":"PIN FX TEMP CERV LCK PLT NS","code_information":[{"code":"110897","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":125.12,"maximum":375.36,"gross_charge":391,"discounted_cash":226.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":371.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":375.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":285.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":324.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":285.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":187.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":135.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":125.12,"methodology":"fee schedule"}]}]},{"description":"APPLIER LIG MCA MED 11.25IN","code_information":[{"code":"111019","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":132.13,"maximum":173.76,"gross_charge":181,"discounted_cash":104.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":171.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":173.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":150.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":132.13,"methodology":"fee schedule"}]}]},{"description":"APPLIER LIG MCA MED 11.25IN","code_information":[{"code":"111019","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":57.92,"maximum":173.76,"gross_charge":181,"discounted_cash":104.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":171.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":173.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":150.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":62.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":57.92,"methodology":"fee schedule"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1111","type":"APR-DRG"}],"standard_charges":[{"minimum":13920,"maximum":13920,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13920,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1112","type":"APR-DRG"}],"standard_charges":[{"minimum":20925,"maximum":20925,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20925,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1113","type":"APR-DRG"}],"standard_charges":[{"minimum":25264,"maximum":25264,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25264,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VERTIGO AND OTHER LABYRINTH DISORDERS","code_information":[{"code":"1114","type":"APR-DRG"}],"standard_charges":[{"minimum":34441,"maximum":34441,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34441,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SUT SILK 2-0 30IN MP BLK TIES","code_information":[{"code":"112145","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":10.22,"maximum":13.44,"gross_charge":14,"discounted_cash":8.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":13.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":13.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":10.22,"methodology":"fee schedule"}]}]},{"description":"SUT SILK 2-0 30IN MP BLK TIES","code_information":[{"code":"112145","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":4.48,"maximum":13.44,"gross_charge":14,"discounted_cash":8.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":13.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":13.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":10.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":4.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":4.48,"methodology":"fee schedule"}]}]},{"description":"SUT SILK 4-0 18IN PS2 BLK","code_information":[{"code":"112592","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":13.14,"maximum":17.28,"gross_charge":18,"discounted_cash":10.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":17.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":17.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.14,"methodology":"fee schedule"}]}]},{"description":"SUT SILK 4-0 18IN PS2 BLK","code_information":[{"code":"112592","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":5.76,"maximum":17.28,"gross_charge":18,"discounted_cash":10.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":17.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":17.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.76,"methodology":"fee schedule"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1131","type":"APR-DRG"}],"standard_charges":[{"minimum":9972,"maximum":9972,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9972,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1132","type":"APR-DRG"}],"standard_charges":[{"minimum":11377,"maximum":11377,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11377,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1133","type":"APR-DRG"}],"standard_charges":[{"minimum":17501,"maximum":17501,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17501,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INFECTIONS OF UPPER RESPIRATORY TRACT","code_information":[{"code":"1134","type":"APR-DRG"}],"standard_charges":[{"minimum":30836,"maximum":30836,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30836,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ADMIN SET IV BLD FLD WRM STD","code_information":[{"code":"113400","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":34.31,"maximum":45.12,"gross_charge":47,"discounted_cash":27.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":44.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":45.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":34.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":34.31,"methodology":"fee schedule"}]}]},{"description":"ADMIN SET IV BLD FLD WRM STD","code_information":[{"code":"113400","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":15.04,"maximum":45.12,"gross_charge":47,"discounted_cash":27.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":44.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":45.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":34.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":34.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":22.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":15.04,"methodology":"fee schedule"}]}]},{"description":"CATH FOL 3W EMMETT 22FRX30ML","code_information":[{"code":"113979","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":27.74,"maximum":36.48,"gross_charge":38,"discounted_cash":22.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":36.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":36.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":27.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":27.74,"methodology":"fee schedule"}]}]},{"description":"CATH FOL 3W EMMETT 22FRX30ML","code_information":[{"code":"113979","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":12.16,"maximum":36.48,"gross_charge":38,"discounted_cash":22.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":36.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":36.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":27.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":27.74,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":18.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":12.16,"methodology":"fee schedule"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1141","type":"APR-DRG"}],"standard_charges":[{"minimum":10013,"maximum":10013,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10013,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PAD SENS BD ALRM SENSORMAT","code_information":[{"code":"114177","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":81.76,"maximum":107.52,"gross_charge":112,"discounted_cash":64.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":106.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":107.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":81.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":92.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":81.76,"methodology":"fee schedule"}]}]},{"description":"PAD SENS BD ALRM SENSORMAT","code_information":[{"code":"114177","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":35.84,"maximum":107.52,"gross_charge":112,"discounted_cash":64.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":106.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":107.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":81.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":92.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":81.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":53.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":38.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":35.84,"methodology":"fee schedule"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1142","type":"APR-DRG"}],"standard_charges":[{"minimum":15207,"maximum":15207,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15207,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1143","type":"APR-DRG"}],"standard_charges":[{"minimum":22338,"maximum":22338,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22338,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DENTAL DISEASES AND DISORDERS","code_information":[{"code":"1144","type":"APR-DRG"}],"standard_charges":[{"minimum":39093,"maximum":39093,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":39093,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SUT CHROMIC 5-0 18IN P2 BRN","code_information":[{"code":"114663","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":21.9,"maximum":28.8,"gross_charge":30,"discounted_cash":17.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":28.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":28.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.9,"methodology":"fee schedule"}]}]},{"description":"SUT CHROMIC 5-0 18IN P2 BRN","code_information":[{"code":"114663","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":9.6,"maximum":28.8,"gross_charge":30,"discounted_cash":17.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":28.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":28.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":14.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.6,"methodology":"fee schedule"}]}]},{"description":"OTHER EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1151","type":"APR-DRG"}],"standard_charges":[{"minimum":14109,"maximum":14109,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14109,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HLDR CATH ATTACH DEV 12-18FR","code_information":[{"code":"115180","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":10.95,"maximum":14.4,"gross_charge":15,"discounted_cash":8.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":14.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":14.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":10.95,"methodology":"fee schedule"}]}]},{"description":"HLDR CATH ATTACH DEV 12-18FR","code_information":[{"code":"115180","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":4.8,"maximum":14.4,"gross_charge":15,"discounted_cash":8.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":14.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":14.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":10.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":7.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":5.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":4.8,"methodology":"fee schedule"}]}]},{"description":"OTHER EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1152","type":"APR-DRG"}],"standard_charges":[{"minimum":17042,"maximum":17042,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17042,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1153","type":"APR-DRG"}],"standard_charges":[{"minimum":26295,"maximum":26295,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26295,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER EAR NOSE MOUTH THROAT AND CRANIAL OR FACIAL DIAGNOSES","code_information":[{"code":"1154","type":"APR-DRG"}],"standard_charges":[{"minimum":44028,"maximum":44028,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44028,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RETRCT ENDOSCP PADDLE 12MM","code_information":[{"code":"115782","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":112.42,"maximum":147.84,"gross_charge":154,"discounted_cash":89.32,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":146.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":147.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":112.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":127.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":112.42,"methodology":"fee schedule"}]}]},{"description":"RETRCT ENDOSCP PADDLE 12MM","code_information":[{"code":"115782","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":49.28,"maximum":147.84,"gross_charge":154,"discounted_cash":89.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":146.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":147.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":112.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":127.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":112.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":53.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":49.28,"methodology":"fee schedule"}]}]},{"description":"SOL INHAL STRL H2O 2000ML BG","code_information":[{"code":"116314","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":7.95,"maximum":10.46,"gross_charge":10.89,"discounted_cash":6.32,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":10.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":10.46,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7.95,"methodology":"fee schedule"}]}]},{"description":"SOL INHAL STRL H2O 2000ML BG","code_information":[{"code":"116314","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":3.49,"maximum":10.46,"gross_charge":10.89,"discounted_cash":6.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":10.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":10.46,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3.49,"methodology":"fee schedule"}]}]},{"description":"TB TRACH CUF 6 DCT","code_information":[{"code":"116613","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":94.9,"maximum":124.8,"gross_charge":130,"discounted_cash":75.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":123.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":124.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":94.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":107.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":94.9,"methodology":"fee schedule"}]}]},{"description":"TB TRACH CUF 6 DCT","code_information":[{"code":"116613","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":41.6,"maximum":124.8,"gross_charge":130,"discounted_cash":75.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":123.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":124.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":94.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":107.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":94.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":45.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":41.6,"methodology":"fee schedule"}]}]},{"description":"NDL INSUF VERES LL 120MM DISP","code_information":[{"code":"116693","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":37.96,"maximum":49.92,"gross_charge":52,"discounted_cash":30.16,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":49.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":49.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":37.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":37.96,"methodology":"fee schedule"}]}]},{"description":"NDL INSUF VERES LL 120MM DISP","code_information":[{"code":"116693","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":16.64,"maximum":49.92,"gross_charge":52,"discounted_cash":30.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":49.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":49.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":37.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":37.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":24.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":18.04,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.64,"methodology":"fee schedule"}]}]},{"description":"NDL INSUF VERES ENDOPATH 120","code_information":[{"code":"116766","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":44.53,"maximum":58.56,"gross_charge":61,"discounted_cash":35.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":57.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":58.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":44.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":44.53,"methodology":"fee schedule"}]}]},{"description":"NDL INSUF VERES ENDOPATH 120","code_information":[{"code":"116766","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":19.52,"maximum":58.56,"gross_charge":61,"discounted_cash":35.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":57.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":58.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":44.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":44.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":29.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":21.16,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":19.52,"methodology":"fee schedule"}]}]},{"description":"TAP 180 HEX DC SCR 4.2MM","code_information":[{"code":"116779","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":586.19,"maximum":770.88,"gross_charge":803,"discounted_cash":465.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":762.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":770.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":586.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":666.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":586.19,"methodology":"fee schedule"}]}]},{"description":"TAP 180 HEX DC SCR 4.2MM","code_information":[{"code":"116779","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":256.96,"maximum":770.88,"gross_charge":803,"discounted_cash":465.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":762.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":770.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":586.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":666.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":586.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":385.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":278.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":256.96,"methodology":"fee schedule"}]}]},{"description":"NDL BX SFT STD NSAF 14GX6IN","code_information":[{"code":"117102","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":23.36,"maximum":30.72,"gross_charge":32,"discounted_cash":18.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":30.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":30.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":23.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":23.36,"methodology":"fee schedule"}]}]},{"description":"NDL BX SFT STD NSAF 14GX6IN","code_information":[{"code":"117102","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":10.24,"maximum":30.72,"gross_charge":32,"discounted_cash":18.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":30.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":30.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":23.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":23.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":11.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":10.24,"methodology":"fee schedule"}]}]},{"description":"NUT TRNSCONN 11MM TI NS","code_information":[{"code":"117436","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":223.38,"maximum":293.76,"gross_charge":306,"discounted_cash":177.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":290.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":293.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":223.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":253.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":223.38,"methodology":"fee schedule"}]}]},{"description":"NUT TRNSCONN 11MM TI NS","code_information":[{"code":"117436","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":97.92,"maximum":293.76,"gross_charge":306,"discounted_cash":177.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":290.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":293.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":223.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":253.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":223.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":106.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":97.92,"methodology":"fee schedule"}]}]},{"description":"SOL IRR STRL H2O 2000ML BG","code_information":[{"code":"117547","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":20.15,"maximum":26.5,"gross_charge":27.6,"discounted_cash":16.01,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":26.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":26.5,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":20.15,"methodology":"fee schedule"}]}]},{"description":"SOL IRR STRL H2O 2000ML BG","code_information":[{"code":"117547","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":8.84,"maximum":26.5,"gross_charge":27.6,"discounted_cash":16.01,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":26.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":26.5,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":20.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":13.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.84,"methodology":"fee schedule"}]}]},{"description":"SOL D5 250ML BG LF","code_information":[{"code":"118135","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":5.11,"maximum":6.72,"gross_charge":7,"discounted_cash":4.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.11,"methodology":"fee schedule"}]}]},{"description":"SOL D5 250ML BG LF","code_information":[{"code":"118135","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":2.24,"maximum":6.72,"gross_charge":7,"discounted_cash":4.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.24,"methodology":"fee schedule"}]}]},{"description":"BAR TRNVRS CL USS 15MM TI NS","code_information":[{"code":"118378","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1008.86,"maximum":1326.72,"gross_charge":1382,"discounted_cash":801.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1312.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1326.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1008.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1147.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1008.86,"methodology":"fee schedule"}]}]},{"description":"BAR TRNVRS CL USS 15MM TI NS","code_information":[{"code":"118378","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":442.24,"maximum":1326.72,"gross_charge":1382,"discounted_cash":801.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1312.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1326.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1008.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1147.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1008.86,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":663.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":479.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":442.24,"methodology":"fee schedule"}]}]},{"description":"SNARE POLYP MIC OVL 13MM 200CM","code_information":[{"code":"118538","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":53.2,"maximum":69.96,"gross_charge":72.87,"discounted_cash":42.27,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":69.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":69.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":53.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":60.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":53.2,"methodology":"fee schedule"}]}]},{"description":"SNARE POLYP MIC OVL 13MM 200CM","code_information":[{"code":"118538","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":23.32,"maximum":69.96,"gross_charge":72.87,"discounted_cash":42.27,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":69.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":69.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":53.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":60.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":53.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":34.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":25.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":23.32,"methodology":"fee schedule"}]}]},{"description":"SPNG SURGCEL 2X3IN LF STRL","code_information":[{"code":"118544","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":117.53,"maximum":154.56,"gross_charge":161,"discounted_cash":93.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":152.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":154.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":117.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":133.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":117.53,"methodology":"fee schedule"}]}]},{"description":"SPNG SURGCEL 2X3IN LF STRL","code_information":[{"code":"118544","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":51.52,"maximum":154.56,"gross_charge":161,"discounted_cash":93.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":152.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":154.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":117.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":133.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":117.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":55.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":51.52,"methodology":"fee schedule"}]}]},{"description":"DRNGE KT THOR DRY SUC MINI 500","code_information":[{"code":"119352","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":190.53,"maximum":250.56,"gross_charge":261,"discounted_cash":151.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":247.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":250.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":190.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":216.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":190.53,"methodology":"fee schedule"}]}]},{"description":"DRNGE KT THOR DRY SUC MINI 500","code_information":[{"code":"119352","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":83.52,"maximum":250.56,"gross_charge":261,"discounted_cash":151.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":247.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":250.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":190.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":216.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":190.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":125.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":83.52,"methodology":"fee schedule"}]}]},{"description":"DRSNG HYDROFERA BLU 4X4IN","code_information":[{"code":"119599","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":20.44,"maximum":26.88,"gross_charge":28,"discounted_cash":16.24,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":26.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":26.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":20.44,"methodology":"fee schedule"}]}]},{"description":"DRSNG HYDROFERA BLU 4X4IN","code_information":[{"code":"119599","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":8.96,"maximum":26.88,"gross_charge":28,"discounted_cash":16.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":26.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":26.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":20.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":13.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.96,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL READICAT BERRY 450ML","code_information":[{"code":"119699","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":12.2,"maximum":16.05,"gross_charge":16.71,"discounted_cash":9.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":15.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":16.05,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":12.2,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL READICAT BERRY 450ML","code_information":[{"code":"119699","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":5.35,"maximum":16.05,"gross_charge":16.71,"discounted_cash":9.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":15.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":16.05,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":12.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":8.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":5.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.35,"methodology":"fee schedule"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1201","type":"APR-DRG"}],"standard_charges":[{"minimum":44637,"maximum":44637,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44637,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"G-WIRE 0.018","code_information":[{"code":"120158","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":162.06,"maximum":213.12,"gross_charge":222,"discounted_cash":128.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":210.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":213.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":162.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":184.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":162.06,"methodology":"fee schedule"}]}]},{"description":"G-WIRE 0.018","code_information":[{"code":"120158","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":71.04,"maximum":213.12,"gross_charge":222,"discounted_cash":128.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":210.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":213.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":162.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":184.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":162.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":106.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":76.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1202","type":"APR-DRG"}],"standard_charges":[{"minimum":64229,"maximum":64229,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":64229,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1203","type":"APR-DRG"}],"standard_charges":[{"minimum":87230,"maximum":87230,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":87230,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1204","type":"APR-DRG"}],"standard_charges":[{"minimum":121494,"maximum":121494,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":121494,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TACKER ENDOSCP MESH HNDL 5TB","code_information":[{"code":"120940","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":705.18,"maximum":927.36,"gross_charge":966,"discounted_cash":560.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":917.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":927.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":705.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":801.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":705.18,"methodology":"fee schedule"}]}]},{"description":"TACKER ENDOSCP MESH HNDL 5TB","code_information":[{"code":"120940","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":309.12,"maximum":927.36,"gross_charge":966,"discounted_cash":560.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":917.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":927.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":705.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":801.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":705.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":463.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":335.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":309.12,"methodology":"fee schedule"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1211","type":"APR-DRG"}],"standard_charges":[{"minimum":38889,"maximum":38889,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38889,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1212","type":"APR-DRG"}],"standard_charges":[{"minimum":46211,"maximum":46211,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46211,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1213","type":"APR-DRG"}],"standard_charges":[{"minimum":75475,"maximum":75475,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":75475,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER RESPIRATORY AND CHEST PROCEDURES","code_information":[{"code":"1214","type":"APR-DRG"}],"standard_charges":[{"minimum":97571,"maximum":97571,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":97571,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH KT LAV EDLICH 34FRX36IN","code_information":[{"code":"121598","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":18.25,"maximum":24,"gross_charge":25,"discounted_cash":14.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":23.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":18.25,"methodology":"fee schedule"}]}]},{"description":"CATH KT LAV EDLICH 34FRX36IN","code_information":[{"code":"121598","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":8,"maximum":24,"gross_charge":25,"discounted_cash":14.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":23.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":18.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":18.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":8.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC STP-65 2.4X--- NS","code_information":[{"code":"121610","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":280.32,"maximum":368.64,"gross_charge":384,"discounted_cash":222.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":364.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":368.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":280.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":318.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":280.32,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC STP-65 2.4X--- NS","code_information":[{"code":"121610","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":122.88,"maximum":368.64,"gross_charge":384,"discounted_cash":222.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":364.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":368.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":280.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":318.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":280.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":184.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":133.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":122.88,"methodology":"fee schedule"}]}]},{"description":"BUR EGG/OVL FAST CUT 6X9.5X","code_information":[{"code":"121984","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":131.4,"maximum":172.8,"gross_charge":180,"discounted_cash":104.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":171,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":172.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":131.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":149.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":131.4,"methodology":"fee schedule"}]}]},{"description":"BUR EGG/OVL FAST CUT 6X9.5X","code_information":[{"code":"121984","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":57.6,"maximum":172.8,"gross_charge":180,"discounted_cash":104.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":171,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":172.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":131.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":149.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":131.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":62.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":57.6,"methodology":"fee schedule"}]}]},{"description":"FRCP BX HOT 2.8MMX230CM","code_information":[{"code":"122500","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":271.56,"maximum":357.12,"gross_charge":372,"discounted_cash":215.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":353.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":357.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":308.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":271.56,"methodology":"fee schedule"}]}]},{"description":"FRCP BX HOT 2.8MMX230CM","code_information":[{"code":"122500","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":119.04,"maximum":357.12,"gross_charge":372,"discounted_cash":215.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":353.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":357.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":308.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":178.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":129.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"}]}]},{"description":"RELOAD STPLR ENDO CUT 45MM GRN","code_information":[{"code":"122786","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":259.88,"maximum":341.76,"gross_charge":356,"discounted_cash":206.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":338.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":341.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":259.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":295.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":259.88,"methodology":"fee schedule"}]}]},{"description":"RELOAD STPLR ENDO CUT 45MM GRN","code_information":[{"code":"122786","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":113.92,"maximum":341.76,"gross_charge":356,"discounted_cash":206.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":338.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":341.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":259.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":295.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":259.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":123.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":113.92,"methodology":"fee schedule"}]}]},{"description":"BLDE SHV INCIS + STR EP-1 4.5","code_information":[{"code":"123149","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":115.34,"maximum":151.68,"gross_charge":158,"discounted_cash":91.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":150.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":151.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":115.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":115.34,"methodology":"fee schedule"}]}]},{"description":"BLDE SHV INCIS + STR EP-1 4.5","code_information":[{"code":"123149","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":50.56,"maximum":151.68,"gross_charge":158,"discounted_cash":91.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":150.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":151.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":115.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":115.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":54.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":50.56,"methodology":"fee schedule"}]}]},{"description":"ELECTRD ECG MON SNAP FOAM MINI","code_information":[{"code":"123185","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":1.19,"maximum":1.56,"gross_charge":1.62,"discounted_cash":0.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1.19,"methodology":"fee schedule"}]}]},{"description":"ELECTRD ECG MON SNAP FOAM MINI","code_information":[{"code":"123185","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":0.52,"maximum":1.56,"gross_charge":1.62,"discounted_cash":0.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":0.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":0.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.52,"methodology":"fee schedule"}]}]},{"description":"SPINAL SET BIPIVCAIN 25GX3.5X2","code_information":[{"code":"123661","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":41.61,"maximum":54.72,"gross_charge":57,"discounted_cash":33.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":54.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":54.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":41.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":47.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":41.61,"methodology":"fee schedule"}]}]},{"description":"SPINAL SET BIPIVCAIN 25GX3.5X2","code_information":[{"code":"123661","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":18.24,"maximum":54.72,"gross_charge":57,"discounted_cash":33.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":54.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":54.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":41.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":47.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":41.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":27.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.24,"methodology":"fee schedule"}]}]},{"description":"DRNG KT THOR ATS OASIS 2000ML","code_information":[{"code":"123867","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":91.98,"maximum":120.96,"gross_charge":126,"discounted_cash":73.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":119.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":120.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":91.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":104.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":91.98,"methodology":"fee schedule"}]}]},{"description":"DRNG KT THOR ATS OASIS 2000ML","code_information":[{"code":"123867","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":40.32,"maximum":120.96,"gross_charge":126,"discounted_cash":73.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":119.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":120.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":91.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":104.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":91.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":60.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":43.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":40.32,"methodology":"fee schedule"}]}]},{"description":"HOOK HARM ENDOSCP 5MM 32CM","code_information":[{"code":"124153","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":327.04,"maximum":430.08,"gross_charge":448,"discounted_cash":259.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":425.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":430.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":327.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":371.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":327.04,"methodology":"fee schedule"}]}]},{"description":"HOOK HARM ENDOSCP 5MM 32CM","code_information":[{"code":"124153","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":143.36,"maximum":430.08,"gross_charge":448,"discounted_cash":259.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":425.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":430.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":327.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":371.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":327.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":215.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":155.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":143.36,"methodology":"fee schedule"}]}]},{"description":"SOL HEALON 0.55ML","code_information":[{"code":"124246","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":116.8,"maximum":153.6,"gross_charge":160,"discounted_cash":92.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":152,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":153.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":132.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.8,"methodology":"fee schedule"}]}]},{"description":"SOL HEALON 0.55ML","code_information":[{"code":"124246","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":51.2,"maximum":153.6,"gross_charge":160,"discounted_cash":92.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":152,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":153.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":132.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":55.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":51.2,"methodology":"fee schedule"}]}]},{"description":"LIGATOR SPDBND 2.8MM 8.6-11.5","code_information":[{"code":"124415","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":502.97,"maximum":661.44,"gross_charge":689,"discounted_cash":399.62,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":654.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":661.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":502.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":571.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":502.97,"methodology":"fee schedule"}]}]},{"description":"LIGATOR SPDBND 2.8MM 8.6-11.5","code_information":[{"code":"124415","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":220.48,"maximum":661.44,"gross_charge":689,"discounted_cash":399.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":654.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":661.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":502.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":571.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":502.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":330.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":238.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":220.48,"methodology":"fee schedule"}]}]},{"description":"BARRIER SKIN PWD PREM KARAYA","code_information":[{"code":"124998","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":13.14,"maximum":17.28,"gross_charge":18,"discounted_cash":10.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":17.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":17.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.14,"methodology":"fee schedule"}]}]},{"description":"BARRIER SKIN PWD PREM KARAYA","code_information":[{"code":"124998","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":5.76,"maximum":17.28,"gross_charge":18,"discounted_cash":10.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":17.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":17.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.76,"methodology":"fee schedule"}]}]},{"description":"RELOAD SURGDAC 3 0 48IN SULU","code_information":[{"code":"125270","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":292.73,"maximum":384.96,"gross_charge":401,"discounted_cash":232.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":380.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":384.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":292.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":332.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":292.73,"methodology":"fee schedule"}]}]},{"description":"RELOAD SURGDAC 3 0 48IN SULU","code_information":[{"code":"125270","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":128.32,"maximum":384.96,"gross_charge":401,"discounted_cash":232.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":380.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":384.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":292.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":332.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":292.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":192.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":139.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":128.32,"methodology":"fee schedule"}]}]},{"description":"COLLAR CLMP BDY EXT-FX 6.0MM","code_information":[{"code":"126630","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":253.31,"maximum":333.12,"gross_charge":347,"discounted_cash":201.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":329.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":333.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":253.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":288.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":253.31,"methodology":"fee schedule"}]}]},{"description":"COLLAR CLMP BDY EXT-FX 6.0MM","code_information":[{"code":"126630","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":111.04,"maximum":333.12,"gross_charge":347,"discounted_cash":201.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":329.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":333.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":253.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":288.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":253.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":166.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":120.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":111.04,"methodology":"fee schedule"}]}]},{"description":"CATH FOL 3W HEMA LN 22FRX30ML","code_information":[{"code":"126758","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":52.56,"maximum":69.12,"gross_charge":72,"discounted_cash":41.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":68.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":69.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":52.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":59.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":52.56,"methodology":"fee schedule"}]}]},{"description":"CATH FOL 3W HEMA LN 22FRX30ML","code_information":[{"code":"126758","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":23.04,"maximum":69.12,"gross_charge":72,"discounted_cash":41.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":68.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":69.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":52.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":59.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":52.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":34.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":24.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":23.04,"methodology":"fee schedule"}]}]},{"description":"STAPLER INTLUMN CEEA 28MM","code_information":[{"code":"126765","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":656.27,"maximum":863.04,"gross_charge":899,"discounted_cash":521.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":854.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":863.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":656.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":746.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":656.27,"methodology":"fee schedule"}]}]},{"description":"STAPLER INTLUMN CEEA 28MM","code_information":[{"code":"126765","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":287.68,"maximum":863.04,"gross_charge":899,"discounted_cash":521.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":854.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":863.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":656.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":746.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":656.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":431.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":311.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":287.68,"methodology":"fee schedule"}]}]},{"description":"STAPLER INTLUMN CEEA 21MM","code_information":[{"code":"127042","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":662.84,"maximum":871.68,"gross_charge":908,"discounted_cash":526.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":862.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":871.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":662.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":753.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":662.84,"methodology":"fee schedule"}]}]},{"description":"STAPLER INTLUMN CEEA 21MM","code_information":[{"code":"127042","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":290.56,"maximum":871.68,"gross_charge":908,"discounted_cash":526.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":862.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":871.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":662.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":753.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":662.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":435.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":314.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":290.56,"methodology":"fee schedule"}]}]},{"description":"INTRO CATH CHOLGM LAPSCP 4FR","code_information":[{"code":"127252","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":282.51,"maximum":371.52,"gross_charge":387,"discounted_cash":224.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":367.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":371.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":282.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":321.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":282.51,"methodology":"fee schedule"}]}]},{"description":"INTRO CATH CHOLGM LAPSCP 4FR","code_information":[{"code":"127252","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":123.84,"maximum":371.52,"gross_charge":387,"discounted_cash":224.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":367.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":371.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":282.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":321.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":282.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":185.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":134.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":123.84,"methodology":"fee schedule"}]}]},{"description":"CATH URETH INTMIT ROB 14FRX1X1","code_information":[{"code":"129001","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2.92,"maximum":3.84,"gross_charge":4,"discounted_cash":2.32,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.92,"methodology":"fee schedule"}]}]},{"description":"CATH URETH INTMIT ROB 14FRX1X1","code_information":[{"code":"129001","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1.28,"maximum":3.84,"gross_charge":4,"discounted_cash":2.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1.28,"methodology":"fee schedule"}]}]},{"description":"SHEARS HARM SCALP 10MM 34CM","code_information":[{"code":"129011","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":919.07,"maximum":1208.64,"gross_charge":1259,"discounted_cash":730.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1196.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1208.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1044.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":919.07,"methodology":"fee schedule"}]}]},{"description":"SHEARS HARM SCALP 10MM 34CM","code_information":[{"code":"129011","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":402.88,"maximum":1208.64,"gross_charge":1259,"discounted_cash":730.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1196.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1208.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":919.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1044.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":919.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":604.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":436.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":402.88,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL 0 18IN CT2 MP VIOL","code_information":[{"code":"129066","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":30.66,"maximum":40.32,"gross_charge":42,"discounted_cash":24.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":39.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":40.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":30.66,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL 0 18IN CT2 MP VIOL","code_information":[{"code":"129066","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":13.44,"maximum":40.32,"gross_charge":42,"discounted_cash":24.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":39.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":40.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":30.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":20.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.44,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1301","type":"APR-DRG"}],"standard_charges":[{"minimum":82932,"maximum":82932,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":82932,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DRSNG VASELINE 3X36IN STRL","code_information":[{"code":"130172","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":40.88,"maximum":53.76,"gross_charge":56,"discounted_cash":32.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":53.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":53.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.88,"methodology":"fee schedule"}]}]},{"description":"DRSNG VASELINE 3X36IN STRL","code_information":[{"code":"130172","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":17.92,"maximum":53.76,"gross_charge":56,"discounted_cash":32.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":53.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":53.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":17.92,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1302","type":"APR-DRG"}],"standard_charges":[{"minimum":84079,"maximum":84079,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":84079,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1303","type":"APR-DRG"}],"standard_charges":[{"minimum":134197,"maximum":134197,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":134197,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS","code_information":[{"code":"1304","type":"APR-DRG"}],"standard_charges":[{"minimum":191032,"maximum":191032,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":191032,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1311","type":"APR-DRG"}],"standard_charges":[{"minimum":27525,"maximum":27525,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27525,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1312","type":"APR-DRG"}],"standard_charges":[{"minimum":31625,"maximum":31625,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31625,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1313","type":"APR-DRG"}],"standard_charges":[{"minimum":48343,"maximum":48343,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48343,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CYSTIC FIBROSIS - PULMONARY DISEASE","code_information":[{"code":"1314","type":"APR-DRG"}],"standard_charges":[{"minimum":66961,"maximum":66961,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":66961,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BIT DRL QC STP-65 2.0X165 NS","code_information":[{"code":"131591","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":388.36,"maximum":510.72,"gross_charge":532,"discounted_cash":308.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":505.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":510.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":388.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":441.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":388.36,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC STP-65 2.0X165 NS","code_information":[{"code":"131591","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":170.24,"maximum":510.72,"gross_charge":532,"discounted_cash":308.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":505.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":510.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":388.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":441.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":388.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":255.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":184.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":170.24,"methodology":"fee schedule"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1321","type":"APR-DRG"}],"standard_charges":[{"minimum":9950,"maximum":9950,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9950,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1322","type":"APR-DRG"}],"standard_charges":[{"minimum":15731,"maximum":15731,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15731,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1323","type":"APR-DRG"}],"standard_charges":[{"minimum":45508,"maximum":45508,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45508,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD","code_information":[{"code":"1324","type":"APR-DRG"}],"standard_charges":[{"minimum":72507,"maximum":72507,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":72507,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STAPLER SKIN APPOSE 35 REG","code_information":[{"code":"133047","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":21.25,"maximum":27.94,"gross_charge":29.1,"discounted_cash":16.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":27.94,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.25,"methodology":"fee schedule"}]}]},{"description":"STAPLER SKIN APPOSE 35 REG","code_information":[{"code":"133047","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":9.32,"maximum":27.94,"gross_charge":29.1,"discounted_cash":16.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":27.94,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":13.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.32,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1331","type":"APR-DRG"}],"standard_charges":[{"minimum":11398,"maximum":11398,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11398,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HANDPIECE IRR FAN INTERPULSE","code_information":[{"code":"133124","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":171.55,"maximum":225.6,"gross_charge":235,"discounted_cash":136.3,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":223.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":225.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":171.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":195.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":171.55,"methodology":"fee schedule"}]}]},{"description":"HANDPIECE IRR FAN INTERPULSE","code_information":[{"code":"133124","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":75.2,"maximum":225.6,"gross_charge":235,"discounted_cash":136.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":223.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":225.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":171.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":195.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":171.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":112.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":81.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":75.2,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1332","type":"APR-DRG"}],"standard_charges":[{"minimum":17870,"maximum":17870,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17870,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1333","type":"APR-DRG"}],"standard_charges":[{"minimum":26371,"maximum":26371,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26371,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RESPIRATORY FAILURE","code_information":[{"code":"1334","type":"APR-DRG"}],"standard_charges":[{"minimum":39960,"maximum":39960,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":39960,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BARRIER SENSI-CARE PROT LV 3","code_information":[{"code":"134095","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":16.06,"maximum":21.12,"gross_charge":22,"discounted_cash":12.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":20.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":21.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.06,"methodology":"fee schedule"}]}]},{"description":"BARRIER SENSI-CARE PROT LV 3","code_information":[{"code":"134095","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":7.04,"maximum":21.12,"gross_charge":22,"discounted_cash":12.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":20.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":21.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":10.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.04,"methodology":"fee schedule"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1341","type":"APR-DRG"}],"standard_charges":[{"minimum":12209,"maximum":12209,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12209,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1342","type":"APR-DRG"}],"standard_charges":[{"minimum":16444,"maximum":16444,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16444,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1343","type":"APR-DRG"}],"standard_charges":[{"minimum":36247,"maximum":36247,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36247,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INJ KT SPECTRIS SOLARIS","code_information":[{"code":"134357","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":38.69,"maximum":50.88,"gross_charge":53,"discounted_cash":30.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":50.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":50.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":38.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":38.69,"methodology":"fee schedule"}]}]},{"description":"INJ KT SPECTRIS SOLARIS","code_information":[{"code":"134357","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":16.96,"maximum":50.88,"gross_charge":53,"discounted_cash":30.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":50.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":50.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":38.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":38.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":25.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":18.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.96,"methodology":"fee schedule"}]}]},{"description":"PULMONARY EMBOLISM","code_information":[{"code":"1344","type":"APR-DRG"}],"standard_charges":[{"minimum":59952,"maximum":59952,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":59952,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DRSNG DUODERM SIGNAL 8.3X8.7IN","code_information":[{"code":"134506","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":32.85,"maximum":43.2,"gross_charge":45,"discounted_cash":26.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":42.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":43.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":32.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":37.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":32.85,"methodology":"fee schedule"}]}]},{"description":"DRSNG DUODERM SIGNAL 8.3X8.7IN","code_information":[{"code":"134506","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":14.4,"maximum":43.2,"gross_charge":45,"discounted_cash":26.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":42.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":43.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":32.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":37.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":32.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":21.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":15.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":14.4,"methodology":"fee schedule"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1351","type":"APR-DRG"}],"standard_charges":[{"minimum":15383,"maximum":15383,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15383,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1352","type":"APR-DRG"}],"standard_charges":[{"minimum":16738,"maximum":16738,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16738,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1353","type":"APR-DRG"}],"standard_charges":[{"minimum":18242,"maximum":18242,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18242,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR CHEST AND RESPIRATORY TRAUMA","code_information":[{"code":"1354","type":"APR-DRG"}],"standard_charges":[{"minimum":38417,"maximum":38417,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38417,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HANDPIECE DIV LIGASURE V SM","code_information":[{"code":"135966","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":900.09,"maximum":1183.68,"gross_charge":1233,"discounted_cash":715.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1171.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1183.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":900.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1023.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":900.09,"methodology":"fee schedule"}]}]},{"description":"HANDPIECE DIV LIGASURE V SM","code_information":[{"code":"135966","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":394.56,"maximum":1183.68,"gross_charge":1233,"discounted_cash":715.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1171.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1183.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":900.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1023.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":900.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":591.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":427.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":394.56,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1361","type":"APR-DRG"}],"standard_charges":[{"minimum":15651,"maximum":15651,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15651,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BAR TRN EXT-FX 3.5X120 TI NS","code_information":[{"code":"136123","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":465.01,"maximum":611.52,"gross_charge":637,"discounted_cash":369.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":605.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":611.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":465.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":528.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":465.01,"methodology":"fee schedule"}]}]},{"description":"BAR TRN EXT-FX 3.5X120 TI NS","code_information":[{"code":"136123","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":203.84,"maximum":611.52,"gross_charge":637,"discounted_cash":369.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":605.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":611.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":465.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":528.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":465.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":305.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":220.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":203.84,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1362","type":"APR-DRG"}],"standard_charges":[{"minimum":22055,"maximum":22055,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22055,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1363","type":"APR-DRG"}],"standard_charges":[{"minimum":39362,"maximum":39362,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":39362,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH SET ART VEN 20GX10.8CM LF","code_information":[{"code":"136331","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":40.15,"maximum":52.8,"gross_charge":55,"discounted_cash":31.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":52.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":52.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":45.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.15,"methodology":"fee schedule"}]}]},{"description":"CATH SET ART VEN 20GX10.8CM LF","code_information":[{"code":"136331","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":17.6,"maximum":52.8,"gross_charge":55,"discounted_cash":31.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":52.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":52.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":45.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":17.6,"methodology":"fee schedule"}]}]},{"description":"RESPIRATORY MALIGNANCY","code_information":[{"code":"1364","type":"APR-DRG"}],"standard_charges":[{"minimum":52576,"maximum":52576,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":52576,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1371","type":"APR-DRG"}],"standard_charges":[{"minimum":11761,"maximum":11761,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11761,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1372","type":"APR-DRG"}],"standard_charges":[{"minimum":16405,"maximum":16405,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16405,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1373","type":"APR-DRG"}],"standard_charges":[{"minimum":27762,"maximum":27762,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27762,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BIT DRL QC 2.7X100 NS","code_information":[{"code":"137332","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":210.97,"maximum":277.44,"gross_charge":289,"discounted_cash":167.62,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":274.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":277.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":210.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":239.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":210.97,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC 2.7X100 NS","code_information":[{"code":"137332","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":92.48,"maximum":277.44,"gross_charge":289,"discounted_cash":167.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":274.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":277.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":210.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":239.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":210.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":138.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":100.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":92.48,"methodology":"fee schedule"}]}]},{"description":"MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS","code_information":[{"code":"1374","type":"APR-DRG"}],"standard_charges":[{"minimum":50091,"maximum":50091,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50091,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH KT GASTSTMY PEG PUL 20FR","code_information":[{"code":"137588","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":210.24,"maximum":276.48,"gross_charge":288,"discounted_cash":167.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":273.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":276.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":210.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":239.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":210.24,"methodology":"fee schedule"}]}]},{"description":"CATH KT GASTSTMY PEG PUL 20FR","code_information":[{"code":"137588","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":92.16,"maximum":276.48,"gross_charge":288,"discounted_cash":167.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":273.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":276.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":210.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":239.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":210.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":138.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":99.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":92.16,"methodology":"fee schedule"}]}]},{"description":"SPLNT KNEE LG 20IN","code_information":[{"code":"137934","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":28.47,"maximum":37.44,"gross_charge":39,"discounted_cash":22.62,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":37.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":28.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":28.47,"methodology":"fee schedule"}]}]},{"description":"SPLNT KNEE LG 20IN","code_information":[{"code":"137934","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":12.48,"maximum":37.44,"gross_charge":39,"discounted_cash":22.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":37.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":28.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":32.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":28.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":18.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":12.48,"methodology":"fee schedule"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1381","type":"APR-DRG"}],"standard_charges":[{"minimum":7892,"maximum":7892,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":7892,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1382","type":"APR-DRG"}],"standard_charges":[{"minimum":11372,"maximum":11372,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11372,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1383","type":"APR-DRG"}],"standard_charges":[{"minimum":19825,"maximum":19825,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19825,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BRONCHIOLITIS AND RSV PNEUMONIA","code_information":[{"code":"1384","type":"APR-DRG"}],"standard_charges":[{"minimum":42426,"maximum":42426,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":42426,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COLLAR TRNSCONN BAR TI NS","code_information":[{"code":"138800","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":256.23,"maximum":336.96,"gross_charge":351,"discounted_cash":203.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":333.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":336.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":256.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":291.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":256.23,"methodology":"fee schedule"}]}]},{"description":"COLLAR TRNSCONN BAR TI NS","code_information":[{"code":"138800","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":112.32,"maximum":336.96,"gross_charge":351,"discounted_cash":203.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":333.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":336.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":256.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":291.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":256.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":168.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":121.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":112.32,"methodology":"fee schedule"}]}]},{"description":"SUT ETHBND 0 18IN MO7 MP GRN","code_information":[{"code":"138999","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":35.77,"maximum":47.04,"gross_charge":49,"discounted_cash":28.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":46.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.77,"methodology":"fee schedule"}]}]},{"description":"SUT ETHBND 0 18IN MO7 MP GRN","code_information":[{"code":"138999","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":15.68,"maximum":47.04,"gross_charge":49,"discounted_cash":28.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":46.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":15.68,"methodology":"fee schedule"}]}]},{"description":"CATH FOL 3W BARD LUB 22FR 30ML","code_information":[{"code":"139085","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":24.09,"maximum":31.68,"gross_charge":33,"discounted_cash":19.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":31.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":31.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":24.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":24.09,"methodology":"fee schedule"}]}]},{"description":"CATH FOL 3W BARD LUB 22FR 30ML","code_information":[{"code":"139085","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":10.56,"maximum":31.68,"gross_charge":33,"discounted_cash":19.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":31.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":31.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":24.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":24.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":11.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":10.56,"methodology":"fee schedule"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1391","type":"APR-DRG"}],"standard_charges":[{"minimum":9731,"maximum":9731,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9731,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1392","type":"APR-DRG"}],"standard_charges":[{"minimum":12400,"maximum":12400,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12400,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1393","type":"APR-DRG"}],"standard_charges":[{"minimum":23451,"maximum":23451,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23451,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PNEUMONIA","code_information":[{"code":"1394","type":"APR-DRG"}],"standard_charges":[{"minimum":84340,"maximum":84340,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":84340,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STAPLER SKIN NOVA + 35 REG","code_information":[{"code":"139683","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":21.17,"maximum":27.84,"gross_charge":29,"discounted_cash":16.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":27.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.17,"methodology":"fee schedule"}]}]},{"description":"STAPLER SKIN NOVA + 35 REG","code_information":[{"code":"139683","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":9.28,"maximum":27.84,"gross_charge":29,"discounted_cash":16.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":27.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":13.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.28,"methodology":"fee schedule"}]}]},{"description":"DISSECTOR ENDOSCP BLLN PREPEX1","code_information":[{"code":"139925","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":837.31,"maximum":1101.12,"gross_charge":1147,"discounted_cash":665.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1089.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1101.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":837.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":952.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":837.31,"methodology":"fee schedule"}]}]},{"description":"DISSECTOR ENDOSCP BLLN PREPEX1","code_information":[{"code":"139925","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":367.04,"maximum":1101.12,"gross_charge":1147,"discounted_cash":665.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1089.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1101.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":837.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":952.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":837.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":550.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":397.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":367.04,"methodology":"fee schedule"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1401","type":"APR-DRG"}],"standard_charges":[{"minimum":10744,"maximum":10744,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10744,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1402","type":"APR-DRG"}],"standard_charges":[{"minimum":12659,"maximum":12659,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12659,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1403","type":"APR-DRG"}],"standard_charges":[{"minimum":17505,"maximum":17505,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17505,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHRONIC OBSTRUCTIVE PULMONARY DISEASE","code_information":[{"code":"1404","type":"APR-DRG"}],"standard_charges":[{"minimum":27045,"maximum":27045,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27045,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RELOAD SURGDAC 0 48IN SULU GRN","code_information":[{"code":"140594","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":59.13,"maximum":77.76,"gross_charge":81,"discounted_cash":46.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":76.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":77.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":59.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":59.13,"methodology":"fee schedule"}]}]},{"description":"RELOAD SURGDAC 0 48IN SULU GRN","code_information":[{"code":"140594","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":25.92,"maximum":77.76,"gross_charge":81,"discounted_cash":46.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":76.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":77.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":59.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":59.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":28.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":25.92,"methodology":"fee schedule"}]}]},{"description":"ASTHMA","code_information":[{"code":"1411","type":"APR-DRG"}],"standard_charges":[{"minimum":9711,"maximum":9711,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9711,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ASTHMA","code_information":[{"code":"1412","type":"APR-DRG"}],"standard_charges":[{"minimum":10055,"maximum":10055,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10055,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ASTHMA","code_information":[{"code":"1413","type":"APR-DRG"}],"standard_charges":[{"minimum":12092,"maximum":12092,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12092,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ASTHMA","code_information":[{"code":"1414","type":"APR-DRG"}],"standard_charges":[{"minimum":30719,"maximum":30719,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30719,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COLLAR CERV EXTRIC UNIV AD","code_information":[{"code":"141590","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":51.83,"maximum":68.16,"gross_charge":71,"discounted_cash":41.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":67.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":68.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":51.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":58.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":51.83,"methodology":"fee schedule"}]}]},{"description":"COLLAR CERV EXTRIC UNIV AD","code_information":[{"code":"141590","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":22.72,"maximum":68.16,"gross_charge":71,"discounted_cash":41.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":67.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":68.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":51.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":58.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":51.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":34.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":24.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":22.72,"methodology":"fee schedule"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1421","type":"APR-DRG"}],"standard_charges":[{"minimum":15433,"maximum":15433,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15433,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1422","type":"APR-DRG"}],"standard_charges":[{"minimum":20273,"maximum":20273,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20273,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1423","type":"APR-DRG"}],"standard_charges":[{"minimum":30771,"maximum":30771,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30771,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BAG DRNGE BILI T TB ADPT 19OZ","code_information":[{"code":"142318","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":26.28,"maximum":34.56,"gross_charge":36,"discounted_cash":20.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":34.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":34.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":26.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":26.28,"methodology":"fee schedule"}]}]},{"description":"BAG DRNGE BILI T TB ADPT 19OZ","code_information":[{"code":"142318","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":11.52,"maximum":34.56,"gross_charge":36,"discounted_cash":20.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":34.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":34.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":26.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":26.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":17.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":12.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":11.52,"methodology":"fee schedule"}]}]},{"description":"INTERSTITIAL AND ALVEOLAR LUNG DISEASES","code_information":[{"code":"1424","type":"APR-DRG"}],"standard_charges":[{"minimum":39212,"maximum":39212,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":39212,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PAD DEFIB CPR AED","code_information":[{"code":"142661","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":106.58,"maximum":140.16,"gross_charge":146,"discounted_cash":84.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":138.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":140.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":106.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":121.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":106.58,"methodology":"fee schedule"}]}]},{"description":"PAD DEFIB CPR AED","code_information":[{"code":"142661","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":46.72,"maximum":140.16,"gross_charge":146,"discounted_cash":84.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":138.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":140.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":106.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":121.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":106.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":70.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":50.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":46.72,"methodology":"fee schedule"}]}]},{"description":"CANN SET ARTHSCP 5.5X70MM","code_information":[{"code":"143084","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":55.48,"maximum":72.96,"gross_charge":76,"discounted_cash":44.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":72.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":72.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":55.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":63.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":55.48,"methodology":"fee schedule"}]}]},{"description":"CANN SET ARTHSCP 5.5X70MM","code_information":[{"code":"143084","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":24.32,"maximum":72.96,"gross_charge":76,"discounted_cash":44.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":72.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":72.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":55.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":63.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":55.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":36.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":26.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":24.32,"methodology":"fee schedule"}]}]},{"description":"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1431","type":"APR-DRG"}],"standard_charges":[{"minimum":14414,"maximum":14414,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14414,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1432","type":"APR-DRG"}],"standard_charges":[{"minimum":19099,"maximum":19099,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19099,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1433","type":"APR-DRG"}],"standard_charges":[{"minimum":19207,"maximum":19207,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19207,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1434","type":"APR-DRG"}],"standard_charges":[{"minimum":40102,"maximum":40102,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":40102,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RESPIRATORY SIGNS SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1441","type":"APR-DRG"}],"standard_charges":[{"minimum":9998,"maximum":9998,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9998,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RESPIRATORY SIGNS SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1442","type":"APR-DRG"}],"standard_charges":[{"minimum":15522,"maximum":15522,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15522,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RESPIRATORY SIGNS SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1443","type":"APR-DRG"}],"standard_charges":[{"minimum":19457,"maximum":19457,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19457,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RESPIRATORY SIGNS SYMPTOMS AND MISCELLANEOUS DIAGNOSES","code_information":[{"code":"1444","type":"APR-DRG"}],"standard_charges":[{"minimum":41549,"maximum":41549,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41549,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH ESOPH CRE 8-10MMX8CM 6FR","code_information":[{"code":"144856","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":430.7,"maximum":566.4,"gross_charge":590,"discounted_cash":342.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":560.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":566.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":430.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":489.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":430.7,"methodology":"fee schedule"}]}]},{"description":"CATH ESOPH CRE 8-10MMX8CM 6FR","code_information":[{"code":"144856","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":188.8,"maximum":566.4,"gross_charge":590,"discounted_cash":342.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":560.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":566.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":430.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":489.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":430.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":283.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":204.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":188.8,"methodology":"fee schedule"}]}]},{"description":"ACUTE BRONCHITIS AND RELATED SYMPTOMS","code_information":[{"code":"1451","type":"APR-DRG"}],"standard_charges":[{"minimum":10387,"maximum":10387,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10387,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BAR TRNVRS AXON 3.5MM TI NS","code_information":[{"code":"145123","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":524.14,"maximum":689.28,"gross_charge":718,"discounted_cash":416.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":682.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":689.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":524.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":595.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":524.14,"methodology":"fee schedule"}]}]},{"description":"BAR TRNVRS AXON 3.5MM TI NS","code_information":[{"code":"145123","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":229.76,"maximum":689.28,"gross_charge":718,"discounted_cash":416.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":682.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":689.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":524.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":595.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":524.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":344.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":249.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":229.76,"methodology":"fee schedule"}]}]},{"description":"ACUTE BRONCHITIS AND RELATED SYMPTOMS","code_information":[{"code":"1452","type":"APR-DRG"}],"standard_charges":[{"minimum":15127,"maximum":15127,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15127,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE BRONCHITIS AND RELATED SYMPTOMS","code_information":[{"code":"1453","type":"APR-DRG"}],"standard_charges":[{"minimum":20470,"maximum":20470,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20470,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE BRONCHITIS AND RELATED SYMPTOMS","code_information":[{"code":"1454","type":"APR-DRG"}],"standard_charges":[{"minimum":30366,"maximum":30366,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30366,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTRD SENS BIS MON STRP AD","code_information":[{"code":"145458","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":51.83,"maximum":68.16,"gross_charge":71,"discounted_cash":41.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":67.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":68.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":51.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":58.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":51.83,"methodology":"fee schedule"}]}]},{"description":"ELECTRD SENS BIS MON STRP AD","code_information":[{"code":"145458","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":22.72,"maximum":68.16,"gross_charge":71,"discounted_cash":41.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":67.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":68.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":51.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":58.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":51.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":34.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":24.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":22.72,"methodology":"fee schedule"}]}]},{"description":"CATH CHOLGM 7.5FRX18IN","code_information":[{"code":"147130","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":138.7,"maximum":182.4,"gross_charge":190,"discounted_cash":110.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":180.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":182.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":138.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":157.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":138.7,"methodology":"fee schedule"}]}]},{"description":"CATH CHOLGM 7.5FRX18IN","code_information":[{"code":"147130","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":60.8,"maximum":182.4,"gross_charge":190,"discounted_cash":110.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":180.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":182.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":138.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":157.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":138.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":91.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":65.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":60.8,"methodology":"fee schedule"}]}]},{"description":"BUR SHV INCIS HELICUT 4.5MM","code_information":[{"code":"147557","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":248.2,"maximum":326.4,"gross_charge":340,"discounted_cash":197.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":323,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":326.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":248.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":282.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":248.2,"methodology":"fee schedule"}]}]},{"description":"BUR SHV INCIS HELICUT 4.5MM","code_information":[{"code":"147557","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":108.8,"maximum":326.4,"gross_charge":340,"discounted_cash":197.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":323,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":326.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":248.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":282.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":248.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":163.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":117.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":108.8,"methodology":"fee schedule"}]}]},{"description":"CATH FOL COUDE TIEM 20FRX5ML","code_information":[{"code":"147978","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":67.89,"maximum":89.28,"gross_charge":93,"discounted_cash":53.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":88.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":89.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":67.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":67.89,"methodology":"fee schedule"}]}]},{"description":"CATH FOL COUDE TIEM 20FRX5ML","code_information":[{"code":"147978","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":29.76,"maximum":89.28,"gross_charge":93,"discounted_cash":53.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":88.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":89.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":67.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":67.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.26,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":29.76,"methodology":"fee schedule"}]}]},{"description":"SET IV BLD FLD WRM W INJ PRT","code_information":[{"code":"148230","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":29.2,"maximum":38.4,"gross_charge":40,"discounted_cash":23.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.2,"methodology":"fee schedule"}]}]},{"description":"SET IV BLD FLD WRM W INJ PRT","code_information":[{"code":"148230","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":12.8,"maximum":38.4,"gross_charge":40,"discounted_cash":23.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":12.8,"methodology":"fee schedule"}]}]},{"description":"BIT DRL CERV STP 3.0X16 NS","code_information":[{"code":"149200","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":454.06,"maximum":597.12,"gross_charge":622,"discounted_cash":360.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":590.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":597.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":454.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":516.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":454.06,"methodology":"fee schedule"}]}]},{"description":"BIT DRL CERV STP 3.0X16 NS","code_information":[{"code":"149200","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":199.04,"maximum":597.12,"gross_charge":622,"discounted_cash":360.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":590.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":597.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":454.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":516.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":454.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":298.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":215.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":199.04,"methodology":"fee schedule"}]}]},{"description":"CATH KT CRICO UNCUF 6MMX7.5CM","code_information":[{"code":"150162","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":364.27,"maximum":479.04,"gross_charge":499,"discounted_cash":289.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":474.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":479.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":364.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":414.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":364.27,"methodology":"fee schedule"}]}]},{"description":"CATH KT CRICO UNCUF 6MMX7.5CM","code_information":[{"code":"150162","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":159.68,"maximum":479.04,"gross_charge":499,"discounted_cash":289.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":474.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":479.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":364.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":414.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":364.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":173.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":159.68,"methodology":"fee schedule"}]}]},{"description":"SPNG SURGCEL 4X8IN LF STRL","code_information":[{"code":"150164","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":214.62,"maximum":282.24,"gross_charge":294,"discounted_cash":170.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":279.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":282.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":214.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":244.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":214.62,"methodology":"fee schedule"}]}]},{"description":"SPNG SURGCEL 4X8IN LF STRL","code_information":[{"code":"150164","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":94.08,"maximum":282.24,"gross_charge":294,"discounted_cash":170.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":279.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":282.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":214.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":244.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":214.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":141.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":101.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":94.08,"methodology":"fee schedule"}]}]},{"description":"PAD GRND REM POLYHESIVE II 9FT","code_information":[{"code":"151353","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":12.41,"maximum":16.32,"gross_charge":17,"discounted_cash":9.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":16.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":16.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":12.41,"methodology":"fee schedule"}]}]},{"description":"PAD GRND REM POLYHESIVE II 9FT","code_information":[{"code":"151353","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":5.44,"maximum":16.32,"gross_charge":17,"discounted_cash":9.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":16.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":16.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":12.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":8.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":5.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.44,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL POLIBAR 1900ML","code_information":[{"code":"151686","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":144.95,"maximum":190.62,"gross_charge":198.56,"discounted_cash":115.17,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":188.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":190.62,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":144.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":164.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":144.95,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL POLIBAR 1900ML","code_information":[{"code":"151686","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":63.54,"maximum":190.62,"gross_charge":198.56,"discounted_cash":115.17,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":188.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":190.62,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":144.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":164.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":144.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":95.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":68.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":63.54,"methodology":"fee schedule"}]}]},{"description":"BLDE SAW OSC SAG MED 9X25X0.38","code_information":[{"code":"151745","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":87.6,"maximum":115.2,"gross_charge":120,"discounted_cash":69.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":114,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":115.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":87.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":99.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":87.6,"methodology":"fee schedule"}]}]},{"description":"BLDE SAW OSC SAG MED 9X25X0.38","code_information":[{"code":"151745","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":38.4,"maximum":115.2,"gross_charge":120,"discounted_cash":69.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":114,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":115.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":87.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":99.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":87.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":41.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":38.4,"methodology":"fee schedule"}]}]},{"description":"PORT SL MRI ATTACH GROSH 8FR","code_information":[{"code":"153493","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":581.81,"maximum":765.12,"gross_charge":797,"discounted_cash":462.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":757.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":765.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":581.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":661.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":581.81,"methodology":"fee schedule"}]}]},{"description":"PORT SL MRI ATTACH GROSH 8FR","code_information":[{"code":"153493","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":255.04,"maximum":765.12,"gross_charge":797,"discounted_cash":462.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":757.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":765.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":581.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":661.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":581.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":382.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":276.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":255.04,"methodology":"fee schedule"}]}]},{"description":"RETRCT FAN 10MM 36CM","code_information":[{"code":"153612","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":233.6,"maximum":307.2,"gross_charge":320,"discounted_cash":185.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":304,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":307.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":233.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":265.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":233.6,"methodology":"fee schedule"}]}]},{"description":"RETRCT FAN 10MM 36CM","code_information":[{"code":"153612","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":102.4,"maximum":307.2,"gross_charge":320,"discounted_cash":185.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":304,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":307.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":233.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":265.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":233.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":110.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":102.4,"methodology":"fee schedule"}]}]},{"description":"SOL D10 1000ML BG LF","code_information":[{"code":"155126","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":6.57,"maximum":8.64,"gross_charge":9,"discounted_cash":5.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6.57,"methodology":"fee schedule"}]}]},{"description":"SOL D10 1000ML BG LF","code_information":[{"code":"155126","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":2.88,"maximum":8.64,"gross_charge":9,"discounted_cash":5.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.88,"methodology":"fee schedule"}]}]},{"description":"STAPLER INT PRSTRNG 65MM SS","code_information":[{"code":"155579","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":340.91,"maximum":448.32,"gross_charge":467,"discounted_cash":270.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":443.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":448.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":340.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":387.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":340.91,"methodology":"fee schedule"}]}]},{"description":"STAPLER INT PRSTRNG 65MM SS","code_information":[{"code":"155579","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":149.44,"maximum":448.32,"gross_charge":467,"discounted_cash":270.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":443.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":448.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":340.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":387.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":340.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":224.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":161.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":149.44,"methodology":"fee schedule"}]}]},{"description":"FRCP BX CLD ALGTR 2.8X230CM","code_information":[{"code":"155671","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":24.82,"maximum":32.64,"gross_charge":34,"discounted_cash":19.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":32.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":32.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":24.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":24.82,"methodology":"fee schedule"}]}]},{"description":"FRCP BX CLD ALGTR 2.8X230CM","code_information":[{"code":"155671","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":10.88,"maximum":32.64,"gross_charge":34,"discounted_cash":19.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":32.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":32.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":24.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":24.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":16.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":11.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":10.88,"methodology":"fee schedule"}]}]},{"description":"RELOAD STPLR LIN TX 60-3.5MM","code_information":[{"code":"155754","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":121.18,"maximum":159.36,"gross_charge":166,"discounted_cash":96.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":157.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":159.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":121.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":121.18,"methodology":"fee schedule"}]}]},{"description":"RELOAD STPLR LIN TX 60-3.5MM","code_information":[{"code":"155754","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":53.12,"maximum":159.36,"gross_charge":166,"discounted_cash":96.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":157.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":159.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":121.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":121.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":57.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":53.12,"methodology":"fee schedule"}]}]},{"description":"CATH FOL 24FRX5ML SIL X3","code_information":[{"code":"155835","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":14.6,"maximum":19.2,"gross_charge":20,"discounted_cash":11.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":14.6,"methodology":"fee schedule"}]}]},{"description":"CATH FOL 24FRX5ML SIL X3","code_information":[{"code":"155835","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":6.4,"maximum":19.2,"gross_charge":20,"discounted_cash":11.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":14.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":9.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":6.4,"methodology":"fee schedule"}]}]},{"description":"SUT PROL 2-0 30IN SH BLU","code_information":[{"code":"156171","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":9.49,"maximum":12.48,"gross_charge":13,"discounted_cash":7.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":12.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":12.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":9.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":9.49,"methodology":"fee schedule"}]}]},{"description":"SUT PROL 2-0 30IN SH BLU","code_information":[{"code":"156171","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":4.16,"maximum":12.48,"gross_charge":13,"discounted_cash":7.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":12.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":12.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":9.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":9.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":6.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":4.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":4.16,"methodology":"fee schedule"}]}]},{"description":"TB TRACH UNCUF 5.0 PED","code_information":[{"code":"157654","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":70.81,"maximum":93.12,"gross_charge":97,"discounted_cash":56.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":92.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":93.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":70.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":70.81,"methodology":"fee schedule"}]}]},{"description":"TB TRACH UNCUF 5.0 PED","code_information":[{"code":"157654","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":31.04,"maximum":93.12,"gross_charge":97,"discounted_cash":56.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":92.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":93.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":70.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":70.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":33.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":31.04,"methodology":"fee schedule"}]}]},{"description":"RESVR DRN WND JP 100ML X1","code_information":[{"code":"158165","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":32.12,"maximum":42.24,"gross_charge":44,"discounted_cash":25.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":41.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":42.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":32.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":32.12,"methodology":"fee schedule"}]}]},{"description":"RESVR DRN WND JP 100ML X1","code_information":[{"code":"158165","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":14.08,"maximum":42.24,"gross_charge":44,"discounted_cash":25.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":41.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":42.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":32.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":32.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":21.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":15.26,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":14.08,"methodology":"fee schedule"}]}]},{"description":"DRSNG FRME TEGDERM 6X8 TRNSPAR","code_information":[{"code":"158537","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":5.17,"maximum":6.79,"gross_charge":7.07,"discounted_cash":4.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6.79,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.17,"methodology":"fee schedule"}]}]},{"description":"DRSNG FRME TEGDERM 6X8 TRNSPAR","code_information":[{"code":"158537","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2.27,"maximum":6.79,"gross_charge":7.07,"discounted_cash":4.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6.79,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.27,"methodology":"fee schedule"}]}]},{"description":"TRCR ENDOSCP BLNT TIP 10MM X2","code_information":[{"code":"158728","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":493.48,"maximum":648.96,"gross_charge":676,"discounted_cash":392.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":642.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":648.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":493.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":561.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":493.48,"methodology":"fee schedule"}]}]},{"description":"TRCR ENDOSCP BLNT TIP 10MM X2","code_information":[{"code":"158728","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":216.32,"maximum":648.96,"gross_charge":676,"discounted_cash":392.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":642.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":648.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":493.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":561.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":493.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":324.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":234.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":216.32,"methodology":"fee schedule"}]}]},{"description":"CATH KT GASTSTMY PEG 24IN","code_information":[{"code":"159360","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":319.74,"maximum":420.48,"gross_charge":438,"discounted_cash":254.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":416.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":420.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":319.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":363.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":319.74,"methodology":"fee schedule"}]}]},{"description":"CATH KT GASTSTMY PEG 24IN","code_information":[{"code":"159360","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":140.16,"maximum":420.48,"gross_charge":438,"discounted_cash":254.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":416.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":420.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":319.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":363.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":319.74,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":210.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":151.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":140.16,"methodology":"fee schedule"}]}]},{"description":"MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY","code_information":[{"code":"1601","type":"APR-DRG"}],"standard_charges":[{"minimum":73825,"maximum":73825,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":73825,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY","code_information":[{"code":"1602","type":"APR-DRG"}],"standard_charges":[{"minimum":82099,"maximum":82099,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":82099,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY","code_information":[{"code":"1603","type":"APR-DRG"}],"standard_charges":[{"minimum":140303,"maximum":140303,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":140303,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY","code_information":[{"code":"1604","type":"APR-DRG"}],"standard_charges":[{"minimum":261365,"maximum":261365,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":261365,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RELOAD STPLR LIN CUT PROX 55X1","code_information":[{"code":"160527","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":123.37,"maximum":162.24,"gross_charge":169,"discounted_cash":98.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":160.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":162.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":123.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":140.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":123.37,"methodology":"fee schedule"}]}]},{"description":"RELOAD STPLR LIN CUT PROX 55X1","code_information":[{"code":"160527","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":54.08,"maximum":162.24,"gross_charge":169,"discounted_cash":98.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":160.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":162.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":123.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":140.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":123.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":81.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":58.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":54.08,"methodology":"fee schedule"}]}]},{"description":"IMPLANTABLE HEART ASSIST SYSTEMS","code_information":[{"code":"1611","type":"APR-DRG"}],"standard_charges":[{"minimum":360943,"maximum":360943,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":360943,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"IMPLANTABLE HEART ASSIST SYSTEMS","code_information":[{"code":"1612","type":"APR-DRG"}],"standard_charges":[{"minimum":379939,"maximum":379939,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":379939,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"IMPLANTABLE HEART ASSIST SYSTEMS","code_information":[{"code":"1613","type":"APR-DRG"}],"standard_charges":[{"minimum":473204,"maximum":473204,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":473204,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"IMPLANTABLE HEART ASSIST SYSTEMS","code_information":[{"code":"1614","type":"APR-DRG"}],"standard_charges":[{"minimum":617675,"maximum":617675,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":617675,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1621","type":"APR-DRG"}],"standard_charges":[{"minimum":111870,"maximum":111870,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":111870,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SOL NACL 0.9PCT 500ML BG LF","code_information":[{"code":"162109","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":3.65,"maximum":4.8,"gross_charge":5,"discounted_cash":2.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3.65,"methodology":"fee schedule"}]}]},{"description":"SOL NACL 0.9PCT 500ML BG LF","code_information":[{"code":"162109","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":1.6,"maximum":4.8,"gross_charge":5,"discounted_cash":2.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1.6,"methodology":"fee schedule"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1622","type":"APR-DRG"}],"standard_charges":[{"minimum":121657,"maximum":121657,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":121657,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1623","type":"APR-DRG"}],"standard_charges":[{"minimum":143219,"maximum":143219,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":143219,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1624","type":"APR-DRG"}],"standard_charges":[{"minimum":201410,"maximum":201410,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":201410,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BAG DRNGE URIN LEG LG 32OZ X2","code_information":[{"code":"162905","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":13.87,"maximum":18.24,"gross_charge":19,"discounted_cash":11.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":18.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":18.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.87,"methodology":"fee schedule"}]}]},{"description":"BAG DRNGE URIN LEG LG 32OZ X2","code_information":[{"code":"162905","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":6.08,"maximum":18.24,"gross_charge":19,"discounted_cash":11.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":18.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":18.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":9.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":6.08,"methodology":"fee schedule"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1631","type":"APR-DRG"}],"standard_charges":[{"minimum":62320,"maximum":62320,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":62320,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1632","type":"APR-DRG"}],"standard_charges":[{"minimum":71790,"maximum":71790,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":71790,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1633","type":"APR-DRG"}],"standard_charges":[{"minimum":107839,"maximum":107839,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":107839,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1634","type":"APR-DRG"}],"standard_charges":[{"minimum":183770,"maximum":183770,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":183770,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STAPLER INT ROTIC TA 55-3.5MM","code_information":[{"code":"163773","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":460.63,"maximum":605.76,"gross_charge":631,"discounted_cash":365.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":599.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":605.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":460.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":523.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":460.63,"methodology":"fee schedule"}]}]},{"description":"STAPLER INT ROTIC TA 55-3.5MM","code_information":[{"code":"163773","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":201.92,"maximum":605.76,"gross_charge":631,"discounted_cash":365.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":599.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":605.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":460.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":523.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":460.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":302.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":218.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":201.92,"methodology":"fee schedule"}]}]},{"description":"BUR EGG MED 4MM","code_information":[{"code":"163938","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":252.58,"maximum":332.16,"gross_charge":346,"discounted_cash":200.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":328.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":332.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":252.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":287.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":252.58,"methodology":"fee schedule"}]}]},{"description":"BUR EGG MED 4MM","code_information":[{"code":"163938","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":110.72,"maximum":332.16,"gross_charge":346,"discounted_cash":200.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":328.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":332.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":252.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":287.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":252.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":166.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":120,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":110.72,"methodology":"fee schedule"}]}]},{"description":"TAP 50MM SCR CORTX 1.5 NS","code_information":[{"code":"164928","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":267.91,"maximum":352.32,"gross_charge":367,"discounted_cash":212.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":348.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":352.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":267.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":304.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":267.91,"methodology":"fee schedule"}]}]},{"description":"TAP 50MM SCR CORTX 1.5 NS","code_information":[{"code":"164928","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":117.44,"maximum":352.32,"gross_charge":367,"discounted_cash":212.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":348.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":352.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":267.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":304.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":267.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":127.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":117.44,"methodology":"fee schedule"}]}]},{"description":"CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1651","type":"APR-DRG"}],"standard_charges":[{"minimum":66433,"maximum":66433,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":66433,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1652","type":"APR-DRG"}],"standard_charges":[{"minimum":80899,"maximum":80899,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":80899,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1653","type":"APR-DRG"}],"standard_charges":[{"minimum":91643,"maximum":91643,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":91643,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1654","type":"APR-DRG"}],"standard_charges":[{"minimum":128431,"maximum":128431,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":128431,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRCP NDL NOSE GRANDEE","code_information":[{"code":"165533","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":167.9,"maximum":220.8,"gross_charge":230,"discounted_cash":133.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":218.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":220.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":167.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":190.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":167.9,"methodology":"fee schedule"}]}]},{"description":"FRCP NDL NOSE GRANDEE","code_information":[{"code":"165533","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":73.6,"maximum":220.8,"gross_charge":230,"discounted_cash":133.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":218.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":220.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":167.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":190.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":167.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":110.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":79.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":73.6,"methodology":"fee schedule"}]}]},{"description":"PIN FIX TEMP SS","code_information":[{"code":"166067","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":155.49,"maximum":204.48,"gross_charge":213,"discounted_cash":123.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":202.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":204.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":155.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":176.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":155.49,"methodology":"fee schedule"}]}]},{"description":"PIN FIX TEMP SS","code_information":[{"code":"166067","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":68.16,"maximum":204.48,"gross_charge":213,"discounted_cash":123.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":202.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":204.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":155.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":176.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":155.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":102.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":73.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":68.16,"methodology":"fee schedule"}]}]},{"description":"CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1661","type":"APR-DRG"}],"standard_charges":[{"minimum":55363,"maximum":55363,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":55363,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1662","type":"APR-DRG"}],"standard_charges":[{"minimum":64855,"maximum":64855,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":64855,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1663","type":"APR-DRG"}],"standard_charges":[{"minimum":79410,"maximum":79410,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":79410,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"1664","type":"APR-DRG"}],"standard_charges":[{"minimum":138377,"maximum":138377,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":138377,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES","code_information":[{"code":"1671","type":"APR-DRG"}],"standard_charges":[{"minimum":75301,"maximum":75301,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":75301,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRCP BCOCK ENDOSCP 10MM X1","code_information":[{"code":"167120","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":110.23,"maximum":144.96,"gross_charge":151,"discounted_cash":87.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":143.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":144.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":110.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":125.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":110.23,"methodology":"fee schedule"}]}]},{"description":"FRCP BCOCK ENDOSCP 10MM X1","code_information":[{"code":"167120","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":48.32,"maximum":144.96,"gross_charge":151,"discounted_cash":87.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":143.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":144.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":110.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":125.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":110.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":72.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":52.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":48.32,"methodology":"fee schedule"}]}]},{"description":"OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES","code_information":[{"code":"1672","type":"APR-DRG"}],"standard_charges":[{"minimum":78273,"maximum":78273,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":78273,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES","code_information":[{"code":"1673","type":"APR-DRG"}],"standard_charges":[{"minimum":107185,"maximum":107185,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":107185,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH THOR STR TRCR 12FRX9IN","code_information":[{"code":"167328","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":48.91,"maximum":64.32,"gross_charge":67,"discounted_cash":38.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":63.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":64.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":48.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":48.91,"methodology":"fee schedule"}]}]},{"description":"CATH THOR STR TRCR 12FRX9IN","code_information":[{"code":"167328","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":21.44,"maximum":64.32,"gross_charge":67,"discounted_cash":38.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":63.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":64.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":48.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":48.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":32.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":23.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":21.44,"methodology":"fee schedule"}]}]},{"description":"OTHER CARDIOTHORACIC AND THORACIC VASCULAR PROCEDURES","code_information":[{"code":"1674","type":"APR-DRG"}],"standard_charges":[{"minimum":190103,"maximum":190103,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":190103,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR ABDOMINAL VASCULAR PROCEDURES","code_information":[{"code":"1691","type":"APR-DRG"}],"standard_charges":[{"minimum":64566,"maximum":64566,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":64566,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR ABDOMINAL VASCULAR PROCEDURES","code_information":[{"code":"1692","type":"APR-DRG"}],"standard_charges":[{"minimum":78636,"maximum":78636,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":78636,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR ABDOMINAL VASCULAR PROCEDURES","code_information":[{"code":"1693","type":"APR-DRG"}],"standard_charges":[{"minimum":102754,"maximum":102754,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":102754,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR ABDOMINAL VASCULAR PROCEDURES","code_information":[{"code":"1694","type":"APR-DRG"}],"standard_charges":[{"minimum":173890,"maximum":173890,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":173890,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SUT VCRL +0 18IN CT1 MP UD","code_information":[{"code":"170099","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":32,"maximum":42.08,"gross_charge":43.83,"discounted_cash":25.43,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":41.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":42.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":32,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL +0 18IN CT1 MP UD","code_information":[{"code":"170099","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":14.03,"maximum":42.08,"gross_charge":43.83,"discounted_cash":25.43,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":41.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":42.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":21.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":15.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":14.03,"methodology":"fee schedule"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI HEART FAILURE OR SHOCK","code_information":[{"code":"1701","type":"APR-DRG"}],"standard_charges":[{"minimum":56298,"maximum":56298,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":56298,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI HEART FAILURE OR SHOCK","code_information":[{"code":"1702","type":"APR-DRG"}],"standard_charges":[{"minimum":63950,"maximum":63950,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":63950,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI HEART FAILURE OR SHOCK","code_information":[{"code":"1703","type":"APR-DRG"}],"standard_charges":[{"minimum":81103,"maximum":81103,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":81103,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI HEART FAILURE OR SHOCK","code_information":[{"code":"1704","type":"APR-DRG"}],"standard_charges":[{"minimum":114037,"maximum":114037,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":114037,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI HEART FAILURE OR SHOCK","code_information":[{"code":"1711","type":"APR-DRG"}],"standard_charges":[{"minimum":32821,"maximum":32821,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32821,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI HEART FAILURE OR SHOCK","code_information":[{"code":"1712","type":"APR-DRG"}],"standard_charges":[{"minimum":40780,"maximum":40780,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":40780,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI HEART FAILURE OR SHOCK","code_information":[{"code":"1713","type":"APR-DRG"}],"standard_charges":[{"minimum":53089,"maximum":53089,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":53089,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI HEART FAILURE OR SHOCK","code_information":[{"code":"1714","type":"APR-DRG"}],"standard_charges":[{"minimum":85219,"maximum":85219,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":85219,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SOL IRR NACL 0.9PCT 2000ML BG","code_information":[{"code":"171908","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":16.79,"maximum":22.08,"gross_charge":23,"discounted_cash":13.34,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":21.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.79,"methodology":"fee schedule"}]}]},{"description":"SOL IRR NACL 0.9PCT 2000ML BG","code_information":[{"code":"171908","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":7.36,"maximum":22.08,"gross_charge":23,"discounted_cash":13.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":21.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":11.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.36,"methodology":"fee schedule"}]}]},{"description":"STAPLER INT TA 60 DST 3.5MM","code_information":[{"code":"173719","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":594.95,"maximum":782.4,"gross_charge":815,"discounted_cash":472.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":774.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":782.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":594.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":676.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":594.95,"methodology":"fee schedule"}]}]},{"description":"STAPLER INT TA 60 DST 3.5MM","code_information":[{"code":"173719","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":260.8,"maximum":782.4,"gross_charge":815,"discounted_cash":472.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":774.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":782.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":594.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":676.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":594.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":391.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":282.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":260.8,"methodology":"fee schedule"}]}]},{"description":"CATH SET CV TL LIDO 7FRX20CMX5","code_information":[{"code":"173992","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":129.94,"maximum":170.88,"gross_charge":178,"discounted_cash":103.24,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":169.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":170.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":129.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":147.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":129.94,"methodology":"fee schedule"}]}]},{"description":"CATH SET CV TL LIDO 7FRX20CMX5","code_information":[{"code":"173992","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":56.96,"maximum":170.88,"gross_charge":178,"discounted_cash":103.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":169.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":170.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":129.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":147.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":129.94,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":61.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":56.96,"methodology":"fee schedule"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITH AMI","code_information":[{"code":"1741","type":"APR-DRG"}],"standard_charges":[{"minimum":28971,"maximum":28971,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28971,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITH AMI","code_information":[{"code":"1742","type":"APR-DRG"}],"standard_charges":[{"minimum":33864,"maximum":33864,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33864,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITH AMI","code_information":[{"code":"1743","type":"APR-DRG"}],"standard_charges":[{"minimum":43015,"maximum":43015,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43015,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITH AMI","code_information":[{"code":"1744","type":"APR-DRG"}],"standard_charges":[{"minimum":78247,"maximum":78247,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":78247,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BLDE SHV RAZ CUT EP-1 5.5MM","code_information":[{"code":"174611","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":194.91,"maximum":256.32,"gross_charge":267,"discounted_cash":154.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":253.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":256.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":194.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":221.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":194.91,"methodology":"fee schedule"}]}]},{"description":"BLDE SHV RAZ CUT EP-1 5.5MM","code_information":[{"code":"174611","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":85.44,"maximum":256.32,"gross_charge":267,"discounted_cash":154.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":253.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":256.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":194.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":221.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":194.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":128.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":92.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":85.44,"methodology":"fee schedule"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI","code_information":[{"code":"1751","type":"APR-DRG"}],"standard_charges":[{"minimum":36110,"maximum":36110,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36110,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI","code_information":[{"code":"1752","type":"APR-DRG"}],"standard_charges":[{"minimum":40813,"maximum":40813,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":40813,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTRD HEARTSTART + PED DISP","code_information":[{"code":"175241","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":64.97,"maximum":85.44,"gross_charge":89,"discounted_cash":51.62,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":84.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":85.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":64.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":73.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":64.97,"methodology":"fee schedule"}]}]},{"description":"ELECTRD HEARTSTART + PED DISP","code_information":[{"code":"175241","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":28.48,"maximum":85.44,"gross_charge":89,"discounted_cash":51.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":84.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":85.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":64.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":73.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":64.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":42.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":30.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":28.48,"methodology":"fee schedule"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI","code_information":[{"code":"1753","type":"APR-DRG"}],"standard_charges":[{"minimum":55254,"maximum":55254,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":55254,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI","code_information":[{"code":"1754","type":"APR-DRG"}],"standard_charges":[{"minimum":71518,"maximum":71518,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":71518,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SUT MERS 4-0 18IN S2 DA WHT","code_information":[{"code":"175580","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":39.63,"maximum":52.11,"gross_charge":54.28,"discounted_cash":31.49,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":51.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":52.11,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":39.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":45.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":39.63,"methodology":"fee schedule"}]}]},{"description":"SUT MERS 4-0 18IN S2 DA WHT","code_information":[{"code":"175580","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":17.37,"maximum":52.11,"gross_charge":54.28,"discounted_cash":31.49,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":51.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":52.11,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":39.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":45.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":39.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":18.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":17.37,"methodology":"fee schedule"}]}]},{"description":"HOOK PED USS USS OP L TI NS","code_information":[{"code":"175757","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1104.49,"maximum":1452.48,"gross_charge":1513,"discounted_cash":877.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1437.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1452.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1104.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1255.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1104.49,"methodology":"fee schedule"}]}]},{"description":"HOOK PED USS USS OP L TI NS","code_information":[{"code":"175757","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":484.16,"maximum":1452.48,"gross_charge":1513,"discounted_cash":877.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1437.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1452.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1104.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1255.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1104.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":726.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":524.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":484.16,"methodology":"fee schedule"}]}]},{"description":"INSERTION REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES","code_information":[{"code":"1761","type":"APR-DRG"}],"standard_charges":[{"minimum":43154,"maximum":43154,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43154,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INSERTION REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES","code_information":[{"code":"1762","type":"APR-DRG"}],"standard_charges":[{"minimum":53752,"maximum":53752,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":53752,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INSERTION REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES","code_information":[{"code":"1763","type":"APR-DRG"}],"standard_charges":[{"minimum":79312,"maximum":79312,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":79312,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INSERTION REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES","code_information":[{"code":"1764","type":"APR-DRG"}],"standard_charges":[{"minimum":131362,"maximum":131362,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":131362,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH KT THOR TRCR 20FRX10IN","code_information":[{"code":"176584","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":86.14,"maximum":113.28,"gross_charge":118,"discounted_cash":68.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":112.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":113.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":86.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":86.14,"methodology":"fee schedule"}]}]},{"description":"CATH KT THOR TRCR 20FRX10IN","code_information":[{"code":"176584","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":37.76,"maximum":113.28,"gross_charge":118,"discounted_cash":68.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":112.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":113.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":86.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":86.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":40.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":37.76,"methodology":"fee schedule"}]}]},{"description":"CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT","code_information":[{"code":"1771","type":"APR-DRG"}],"standard_charges":[{"minimum":28242,"maximum":28242,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28242,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT","code_information":[{"code":"1772","type":"APR-DRG"}],"standard_charges":[{"minimum":44213,"maximum":44213,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44213,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT","code_information":[{"code":"1773","type":"APR-DRG"}],"standard_charges":[{"minimum":59972,"maximum":59972,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":59972,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BIT DRL QC 2.5X125MM GLD","code_information":[{"code":"177340","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":181.77,"maximum":239.04,"gross_charge":249,"discounted_cash":144.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":236.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":239.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":206.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":181.77,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC 2.5X125MM GLD","code_information":[{"code":"177340","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":79.68,"maximum":239.04,"gross_charge":249,"discounted_cash":144.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":236.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":239.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":206.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":119.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":86.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"}]}]},{"description":"CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT","code_information":[{"code":"1774","type":"APR-DRG"}],"standard_charges":[{"minimum":82745,"maximum":82745,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":82745,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EXTERNAL HEART ASSIST SYSTEMS","code_information":[{"code":"1781","type":"APR-DRG"}],"standard_charges":[{"minimum":128001,"maximum":128001,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":128001,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EXTERNAL HEART ASSIST SYSTEMS","code_information":[{"code":"1782","type":"APR-DRG"}],"standard_charges":[{"minimum":143512,"maximum":143512,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":143512,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EXTERNAL HEART ASSIST SYSTEMS","code_information":[{"code":"1783","type":"APR-DRG"}],"standard_charges":[{"minimum":154037,"maximum":154037,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":154037,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DRNGE KT THOR ATS COMPATIBLE","code_information":[{"code":"178308","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":118.26,"maximum":155.52,"gross_charge":162,"discounted_cash":93.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":153.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":155.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":118.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":134.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":118.26,"methodology":"fee schedule"}]}]},{"description":"DRNGE KT THOR ATS COMPATIBLE","code_information":[{"code":"178308","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":51.84,"maximum":155.52,"gross_charge":162,"discounted_cash":93.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":153.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":155.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":118.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":134.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":118.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":56.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":51.84,"methodology":"fee schedule"}]}]},{"description":"EXTERNAL HEART ASSIST SYSTEMS","code_information":[{"code":"1784","type":"APR-DRG"}],"standard_charges":[{"minimum":195867,"maximum":195867,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":195867,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CANN TRACH INNR SNAP LOK 4MM","code_information":[{"code":"179079","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":86.87,"maximum":114.24,"gross_charge":119,"discounted_cash":69.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":113.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":114.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":86.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":98.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":86.87,"methodology":"fee schedule"}]}]},{"description":"CANN TRACH INNR SNAP LOK 4MM","code_information":[{"code":"179079","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":38.08,"maximum":114.24,"gross_charge":119,"discounted_cash":69.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":113.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":114.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":86.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":98.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":86.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":41.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":38.08,"methodology":"fee schedule"}]}]},{"description":"DEFIBRILLATOR IMPLANTS","code_information":[{"code":"1791","type":"APR-DRG"}],"standard_charges":[{"minimum":61302,"maximum":61302,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":61302,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEFIBRILLATOR IMPLANTS","code_information":[{"code":"1792","type":"APR-DRG"}],"standard_charges":[{"minimum":69472,"maximum":69472,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":69472,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEFIBRILLATOR IMPLANTS","code_information":[{"code":"1793","type":"APR-DRG"}],"standard_charges":[{"minimum":92273,"maximum":92273,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":92273,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEFIBRILLATOR IMPLANTS","code_information":[{"code":"1794","type":"APR-DRG"}],"standard_charges":[{"minimum":156654,"maximum":156654,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":156654,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CIRCULATORY SYSTEM PROCEDURES","code_information":[{"code":"1801","type":"APR-DRG"}],"standard_charges":[{"minimum":27353,"maximum":27353,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27353,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CIRCULATORY SYSTEM PROCEDURES","code_information":[{"code":"1802","type":"APR-DRG"}],"standard_charges":[{"minimum":28303,"maximum":28303,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28303,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CIRCULATORY SYSTEM PROCEDURES","code_information":[{"code":"1803","type":"APR-DRG"}],"standard_charges":[{"minimum":39108,"maximum":39108,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":39108,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CIRCULATORY SYSTEM PROCEDURES","code_information":[{"code":"1804","type":"APR-DRG"}],"standard_charges":[{"minimum":83116,"maximum":83116,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":83116,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH GASTSTMY MIC-KEY 20FRX20","code_information":[{"code":"180594","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":107.31,"maximum":141.12,"gross_charge":147,"discounted_cash":85.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":139.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":141.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":107.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":107.31,"methodology":"fee schedule"}]}]},{"description":"CATH GASTSTMY MIC-KEY 20FRX20","code_information":[{"code":"180594","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":47.04,"maximum":141.12,"gross_charge":147,"discounted_cash":85.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":139.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":141.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":107.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":107.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":70.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":50.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.04,"methodology":"fee schedule"}]}]},{"description":"ELECTRD CUT LOOP 0.035MM 24FR","code_information":[{"code":"180980","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1438.1,"maximum":1891.2,"gross_charge":1970,"discounted_cash":1142.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1871.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1891.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1438.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1635.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1438.1,"methodology":"fee schedule"}]}]},{"description":"ELECTRD CUT LOOP 0.035MM 24FR","code_information":[{"code":"180980","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":630.4,"maximum":1891.2,"gross_charge":1970,"discounted_cash":1142.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1871.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1891.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1438.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1635.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1438.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":945.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":683.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":630.4,"methodology":"fee schedule"}]}]},{"description":"LOWER EXTREMITY ARTERIAL PROCEDURES","code_information":[{"code":"1811","type":"APR-DRG"}],"standard_charges":[{"minimum":32251,"maximum":32251,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32251,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LOWER EXTREMITY ARTERIAL PROCEDURES","code_information":[{"code":"1812","type":"APR-DRG"}],"standard_charges":[{"minimum":44026,"maximum":44026,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44026,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LOWER EXTREMITY ARTERIAL PROCEDURES","code_information":[{"code":"1813","type":"APR-DRG"}],"standard_charges":[{"minimum":75794,"maximum":75794,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":75794,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LOWER EXTREMITY ARTERIAL PROCEDURES","code_information":[{"code":"1814","type":"APR-DRG"}],"standard_charges":[{"minimum":125822,"maximum":125822,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":125822,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COLLAR USS 6MM DUAL-OP IT NS","code_information":[{"code":"181434","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":316.82,"maximum":416.64,"gross_charge":434,"discounted_cash":251.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":412.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":416.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":316.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":360.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":316.82,"methodology":"fee schedule"}]}]},{"description":"COLLAR USS 6MM DUAL-OP IT NS","code_information":[{"code":"181434","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":138.88,"maximum":416.64,"gross_charge":434,"discounted_cash":251.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":412.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":416.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":316.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":360.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":316.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":208.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":150.52,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":138.88,"methodology":"fee schedule"}]}]},{"description":"TY THORACENTESIS/PARACENTESIS","code_information":[{"code":"181446","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":73.73,"maximum":96.96,"gross_charge":101,"discounted_cash":58.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":95.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":96.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":73.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":73.73,"methodology":"fee schedule"}]}]},{"description":"TY THORACENTESIS/PARACENTESIS","code_information":[{"code":"181446","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":32.32,"maximum":96.96,"gross_charge":101,"discounted_cash":58.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":95.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":96.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":73.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":73.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":48.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":35.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":32.32,"methodology":"fee schedule"}]}]},{"description":"OTHER PERIPHERAL VASCULAR PROCEDURES","code_information":[{"code":"1821","type":"APR-DRG"}],"standard_charges":[{"minimum":50163,"maximum":50163,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50163,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PERIPHERAL VASCULAR PROCEDURES","code_information":[{"code":"1822","type":"APR-DRG"}],"standard_charges":[{"minimum":57359,"maximum":57359,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":57359,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPNG KTNR ENDOSCP 5MM STRL","code_information":[{"code":"182245","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":43.07,"maximum":56.64,"gross_charge":59,"discounted_cash":34.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":56.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":56.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":43.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":43.07,"methodology":"fee schedule"}]}]},{"description":"SPNG KTNR ENDOSCP 5MM STRL","code_information":[{"code":"182245","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":18.88,"maximum":56.64,"gross_charge":59,"discounted_cash":34.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":56.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":56.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":43.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":43.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":28.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":20.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.88,"methodology":"fee schedule"}]}]},{"description":"OTHER PERIPHERAL VASCULAR PROCEDURES","code_information":[{"code":"1823","type":"APR-DRG"}],"standard_charges":[{"minimum":71735,"maximum":71735,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":71735,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PERIPHERAL VASCULAR PROCEDURES","code_information":[{"code":"1824","type":"APR-DRG"}],"standard_charges":[{"minimum":102082,"maximum":102082,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":102082,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STOCKING ANTIEMB TH 16MM SM RG","code_information":[{"code":"182875","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":19.71,"maximum":25.92,"gross_charge":27,"discounted_cash":15.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.71,"methodology":"fee schedule"}]}]},{"description":"STOCKING ANTIEMB TH 16MM SM RG","code_information":[{"code":"182875","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":8.64,"maximum":25.92,"gross_charge":27,"discounted_cash":15.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":22.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"}]}]},{"description":"PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES","code_information":[{"code":"1831","type":"APR-DRG"}],"standard_charges":[{"minimum":102935,"maximum":102935,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":102935,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH KT GAST LAV EASI-LAV 24FR","code_information":[{"code":"183126","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":126.29,"maximum":166.08,"gross_charge":173,"discounted_cash":100.34,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":164.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":166.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":126.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":143.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":126.29,"methodology":"fee schedule"}]}]},{"description":"CATH KT GAST LAV EASI-LAV 24FR","code_information":[{"code":"183126","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":55.36,"maximum":166.08,"gross_charge":173,"discounted_cash":100.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":164.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":166.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":126.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":143.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":126.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":83.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":60,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":55.36,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL POLIBAR + 1900ML","code_information":[{"code":"183168","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":36.24,"maximum":47.66,"gross_charge":49.64,"discounted_cash":28.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":47.16,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.66,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":36.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":36.24,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL POLIBAR + 1900ML","code_information":[{"code":"183168","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":15.89,"maximum":47.66,"gross_charge":49.64,"discounted_cash":28.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":47.16,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.66,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":36.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":36.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":17.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":15.89,"methodology":"fee schedule"}]}]},{"description":"PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES","code_information":[{"code":"1832","type":"APR-DRG"}],"standard_charges":[{"minimum":110913,"maximum":110913,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":110913,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES","code_information":[{"code":"1833","type":"APR-DRG"}],"standard_charges":[{"minimum":123577,"maximum":123577,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":123577,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SUT NYL 10-0 12IN AU5 DA BLK","code_information":[{"code":"183329","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":56.21,"maximum":73.92,"gross_charge":77,"discounted_cash":44.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":73.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":73.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":56.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":63.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":56.21,"methodology":"fee schedule"}]}]},{"description":"SUT NYL 10-0 12IN AU5 DA BLK","code_information":[{"code":"183329","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":24.64,"maximum":73.92,"gross_charge":77,"discounted_cash":44.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":73.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":73.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":56.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":63.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":56.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":36.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":26.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":24.64,"methodology":"fee schedule"}]}]},{"description":"PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES","code_information":[{"code":"1834","type":"APR-DRG"}],"standard_charges":[{"minimum":181079,"maximum":181079,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":181079,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"APPLIER LIG ROT ENDOSCP 12MM","code_information":[{"code":"183615","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":244.55,"maximum":321.6,"gross_charge":335,"discounted_cash":194.3,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":318.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":321.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":244.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":278.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":244.55,"methodology":"fee schedule"}]}]},{"description":"APPLIER LIG ROT ENDOSCP 12MM","code_information":[{"code":"183615","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":107.2,"maximum":321.6,"gross_charge":335,"discounted_cash":194.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":318.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":321.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":244.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":278.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":244.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":116.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":107.2,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL READICAT 15OZ","code_information":[{"code":"183672","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":7.55,"maximum":9.92,"gross_charge":10.33,"discounted_cash":6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":9.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":9.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7.55,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL READICAT 15OZ","code_information":[{"code":"183672","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":3.31,"maximum":9.92,"gross_charge":10.33,"discounted_cash":6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":9.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":9.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3.31,"methodology":"fee schedule"}]}]},{"description":"CLAMP FX LP USS TI NS","code_information":[{"code":"183754","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1996.55,"maximum":2625.6,"gross_charge":2735,"discounted_cash":1586.3,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2598.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2625.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1996.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2270.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1996.55,"methodology":"fee schedule"}]}]},{"description":"CLAMP FX LP USS TI NS","code_information":[{"code":"183754","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":875.2,"maximum":2625.6,"gross_charge":2735,"discounted_cash":1586.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2598.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2625.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1996.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2270.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1996.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1312.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":948.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":875.2,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC 1.5X85 NS","code_information":[{"code":"184285","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":184.69,"maximum":242.88,"gross_charge":253,"discounted_cash":146.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":240.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":242.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":184.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":209.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":184.69,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC 1.5X85 NS","code_information":[{"code":"184285","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":80.96,"maximum":242.88,"gross_charge":253,"discounted_cash":146.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":240.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":242.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":184.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":209.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":184.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":121.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":87.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":80.96,"methodology":"fee schedule"}]}]},{"description":"CONN TRNS AXN 60MM TI NS","code_information":[{"code":"185045","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1162.16,"maximum":1528.32,"gross_charge":1592,"discounted_cash":923.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1512.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1528.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1162.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1162.16,"methodology":"fee schedule"}]}]},{"description":"CONN TRNS AXN 60MM TI NS","code_information":[{"code":"185045","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":509.44,"maximum":1528.32,"gross_charge":1592,"discounted_cash":923.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1512.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1528.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1162.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1321.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1162.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":764.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":552.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":509.44,"methodology":"fee schedule"}]}]},{"description":"HANDPIECE LAPSCP COAG OPTI 4","code_information":[{"code":"186573","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":93.44,"maximum":122.88,"gross_charge":128,"discounted_cash":74.24,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":121.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":122.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":93.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":106.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":93.44,"methodology":"fee schedule"}]}]},{"description":"HANDPIECE LAPSCP COAG OPTI 4","code_information":[{"code":"186573","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":40.96,"maximum":122.88,"gross_charge":128,"discounted_cash":74.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":121.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":122.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":93.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":106.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":93.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":61.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":44.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":40.96,"methodology":"fee schedule"}]}]},{"description":"GUIDE SET NDL 21GX1-2CM STRL","code_information":[{"code":"186674","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":63.51,"maximum":83.52,"gross_charge":87,"discounted_cash":50.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":82.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":83.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":63.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":72.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":63.51,"methodology":"fee schedule"}]}]},{"description":"GUIDE SET NDL 21GX1-2CM STRL","code_information":[{"code":"186674","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":27.84,"maximum":83.52,"gross_charge":87,"discounted_cash":50.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":82.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":83.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":63.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":72.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":63.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":41.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":30.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":27.84,"methodology":"fee schedule"}]}]},{"description":"DEVICE SUT ENDO STIT HNDL 10MM","code_information":[{"code":"188201","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":975.28,"maximum":1282.56,"gross_charge":1336,"discounted_cash":774.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1269.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1282.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":975.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1108.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":975.28,"methodology":"fee schedule"}]}]},{"description":"DEVICE SUT ENDO STIT HNDL 10MM","code_information":[{"code":"188201","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":427.52,"maximum":1282.56,"gross_charge":1336,"discounted_cash":774.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1269.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1282.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":975.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1108.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":975.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":641.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":463.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":427.52,"methodology":"fee schedule"}]}]},{"description":"STAPLER INT LIN SAF PROX 55MX1","code_information":[{"code":"188324","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":229.95,"maximum":302.4,"gross_charge":315,"discounted_cash":182.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":299.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":302.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":229.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":261.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":229.95,"methodology":"fee schedule"}]}]},{"description":"STAPLER INT LIN SAF PROX 55MX1","code_information":[{"code":"188324","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":100.8,"maximum":302.4,"gross_charge":315,"discounted_cash":182.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":299.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":302.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":229.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":261.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":229.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":151.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":109.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":100.8,"methodology":"fee schedule"}]}]},{"description":"LENS THER IRR MORGAN MEDI-FLO","code_information":[{"code":"189782","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":66.43,"maximum":87.36,"gross_charge":91,"discounted_cash":52.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":86.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":87.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":66.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":75.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":66.43,"methodology":"fee schedule"}]}]},{"description":"LENS THER IRR MORGAN MEDI-FLO","code_information":[{"code":"189782","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":29.12,"maximum":87.36,"gross_charge":91,"discounted_cash":52.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":86.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":87.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":66.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":75.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":66.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":43.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":31.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":29.12,"methodology":"fee schedule"}]}]},{"description":"BAG DRNGE URIN VLV IC 2000ML","code_information":[{"code":"189814","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":17.26,"maximum":22.7,"gross_charge":23.64,"discounted_cash":13.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":22.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.7,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":17.26,"methodology":"fee schedule"}]}]},{"description":"BAG DRNGE URIN VLV IC 2000ML","code_information":[{"code":"189814","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":7.57,"maximum":22.7,"gross_charge":23.64,"discounted_cash":13.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":22.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.7,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":17.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":11.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":8.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.57,"methodology":"fee schedule"}]}]},{"description":"ACUTE MYOCARDIAL INFARCTION","code_information":[{"code":"1901","type":"APR-DRG"}],"standard_charges":[{"minimum":14188,"maximum":14188,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14188,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE MYOCARDIAL INFARCTION","code_information":[{"code":"1902","type":"APR-DRG"}],"standard_charges":[{"minimum":16703,"maximum":16703,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16703,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE MYOCARDIAL INFARCTION","code_information":[{"code":"1903","type":"APR-DRG"}],"standard_charges":[{"minimum":20733,"maximum":20733,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20733,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE MYOCARDIAL INFARCTION","code_information":[{"code":"1904","type":"APR-DRG"}],"standard_charges":[{"minimum":51326,"maximum":51326,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":51326,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE","code_information":[{"code":"1911","type":"APR-DRG"}],"standard_charges":[{"minimum":14498,"maximum":14498,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14498,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE","code_information":[{"code":"1912","type":"APR-DRG"}],"standard_charges":[{"minimum":15664,"maximum":15664,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15664,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE","code_information":[{"code":"1913","type":"APR-DRG"}],"standard_charges":[{"minimum":35149,"maximum":35149,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":35149,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE","code_information":[{"code":"1914","type":"APR-DRG"}],"standard_charges":[{"minimum":52515,"maximum":52515,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":52515,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STAPLER ENDOSCP TRK HERN 5MM","code_information":[{"code":"191654","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":894.98,"maximum":1176.96,"gross_charge":1226,"discounted_cash":711.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1164.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1176.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":894.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1017.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":894.98,"methodology":"fee schedule"}]}]},{"description":"STAPLER ENDOSCP TRK HERN 5MM","code_information":[{"code":"191654","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":392.32,"maximum":1176.96,"gross_charge":1226,"discounted_cash":711.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1164.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1176.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":894.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1017.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":894.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":588.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":425.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":392.32,"methodology":"fee schedule"}]}]},{"description":"CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS","code_information":[{"code":"1921","type":"APR-DRG"}],"standard_charges":[{"minimum":22501,"maximum":22501,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22501,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPLNT WR/THMB SPICA MED R","code_information":[{"code":"192161","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":39.42,"maximum":51.84,"gross_charge":54,"discounted_cash":31.32,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":51.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":51.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":39.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":44.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":39.42,"methodology":"fee schedule"}]}]},{"description":"SPLNT WR/THMB SPICA MED R","code_information":[{"code":"192161","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":17.28,"maximum":51.84,"gross_charge":54,"discounted_cash":31.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":51.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":51.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":39.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":44.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":39.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":25.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":18.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":17.28,"methodology":"fee schedule"}]}]},{"description":"CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS","code_information":[{"code":"1922","type":"APR-DRG"}],"standard_charges":[{"minimum":23471,"maximum":23471,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23471,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS","code_information":[{"code":"1923","type":"APR-DRG"}],"standard_charges":[{"minimum":29177,"maximum":29177,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29177,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS","code_information":[{"code":"1924","type":"APR-DRG"}],"standard_charges":[{"minimum":49217,"maximum":49217,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":49217,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTRD ARTHSCP ANG BLDE 8.5IN","code_information":[{"code":"192480","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":54.75,"maximum":72,"gross_charge":75,"discounted_cash":43.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":71.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":54.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":62.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":54.75,"methodology":"fee schedule"}]}]},{"description":"ELECTRD ARTHSCP ANG BLDE 8.5IN","code_information":[{"code":"192480","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":24,"maximum":72,"gross_charge":75,"discounted_cash":43.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":71.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":54.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":62.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":54.75,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":26.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":24,"methodology":"fee schedule"}]}]},{"description":"CATH SUPRPUB TRCR 16FRX5ML","code_information":[{"code":"192636","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":96.36,"maximum":126.72,"gross_charge":132,"discounted_cash":76.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":125.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":126.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":96.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":109.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":96.36,"methodology":"fee schedule"}]}]},{"description":"CATH SUPRPUB TRCR 16FRX5ML","code_information":[{"code":"192636","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":42.24,"maximum":126.72,"gross_charge":132,"discounted_cash":76.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":125.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":126.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":96.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":109.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":96.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":63.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":45.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":42.24,"methodology":"fee schedule"}]}]},{"description":"SHEARS ENDOSCP BARI-SHR LN 5MM","code_information":[{"code":"192970","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":793.51,"maximum":1043.52,"gross_charge":1087,"discounted_cash":630.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1032.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1043.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":793.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":902.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":793.51,"methodology":"fee schedule"}]}]},{"description":"SHEARS ENDOSCP BARI-SHR LN 5MM","code_information":[{"code":"192970","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":347.84,"maximum":1043.52,"gross_charge":1087,"discounted_cash":630.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1032.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1043.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":793.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":902.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":793.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":521.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":376.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":347.84,"methodology":"fee schedule"}]}]},{"description":"ACUTE AND SUBACUTE ENDOCARDITIS","code_information":[{"code":"1931","type":"APR-DRG"}],"standard_charges":[{"minimum":19949,"maximum":19949,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19949,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE AND SUBACUTE ENDOCARDITIS","code_information":[{"code":"1932","type":"APR-DRG"}],"standard_charges":[{"minimum":28566,"maximum":28566,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28566,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE AND SUBACUTE ENDOCARDITIS","code_information":[{"code":"1933","type":"APR-DRG"}],"standard_charges":[{"minimum":38756,"maximum":38756,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38756,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE AND SUBACUTE ENDOCARDITIS","code_information":[{"code":"1934","type":"APR-DRG"}],"standard_charges":[{"minimum":50724,"maximum":50724,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50724,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEART FAILURE","code_information":[{"code":"1941","type":"APR-DRG"}],"standard_charges":[{"minimum":13420,"maximum":13420,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13420,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEART FAILURE","code_information":[{"code":"1942","type":"APR-DRG"}],"standard_charges":[{"minimum":15248,"maximum":15248,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15248,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEART FAILURE","code_information":[{"code":"1943","type":"APR-DRG"}],"standard_charges":[{"minimum":24168,"maximum":24168,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24168,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEART FAILURE","code_information":[{"code":"1944","type":"APR-DRG"}],"standard_charges":[{"minimum":56548,"maximum":56548,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":56548,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTRD DEFIB LFEPK ADLT","code_information":[{"code":"195354","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":61.32,"maximum":80.64,"gross_charge":84,"discounted_cash":48.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":79.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":80.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":61.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":69.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":61.32,"methodology":"fee schedule"}]}]},{"description":"ELECTRD DEFIB LFEPK ADLT","code_information":[{"code":"195354","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":26.88,"maximum":80.64,"gross_charge":84,"discounted_cash":48.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":79.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":80.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":61.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":69.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":61.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":29.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":26.88,"methodology":"fee schedule"}]}]},{"description":"CARDIAC ARREST AND SHOCK","code_information":[{"code":"1961","type":"APR-DRG"}],"standard_charges":[{"minimum":9868,"maximum":9868,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9868,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC ARREST AND SHOCK","code_information":[{"code":"1962","type":"APR-DRG"}],"standard_charges":[{"minimum":13846,"maximum":13846,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13846,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC ARREST AND SHOCK","code_information":[{"code":"1963","type":"APR-DRG"}],"standard_charges":[{"minimum":19318,"maximum":19318,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19318,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PIN FX TEMP ACLP","code_information":[{"code":"196347","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":306.6,"maximum":403.2,"gross_charge":420,"discounted_cash":243.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":399,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":403.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":306.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":348.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":306.6,"methodology":"fee schedule"}]}]},{"description":"PIN FX TEMP ACLP","code_information":[{"code":"196347","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":134.4,"maximum":403.2,"gross_charge":420,"discounted_cash":243.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":399,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":403.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":306.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":348.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":306.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":201.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":145.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":134.4,"methodology":"fee schedule"}]}]},{"description":"CARDIAC ARREST AND SHOCK","code_information":[{"code":"1964","type":"APR-DRG"}],"standard_charges":[{"minimum":30045,"maximum":30045,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30045,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PNEUMOTHORAX KT CRV 8FRX16CM","code_information":[{"code":"196646","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":290.54,"maximum":382.08,"gross_charge":398,"discounted_cash":230.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":378.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":382.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":290.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":330.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":290.54,"methodology":"fee schedule"}]}]},{"description":"PNEUMOTHORAX KT CRV 8FRX16CM","code_information":[{"code":"196646","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":127.36,"maximum":382.08,"gross_charge":398,"discounted_cash":230.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":378.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":382.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":290.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":330.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":290.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":191.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":138.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":127.36,"methodology":"fee schedule"}]}]},{"description":"PERIPHERAL AND OTHER VASCULAR DISORDERS","code_information":[{"code":"1971","type":"APR-DRG"}],"standard_charges":[{"minimum":11303,"maximum":11303,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11303,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERIPHERAL AND OTHER VASCULAR DISORDERS","code_information":[{"code":"1972","type":"APR-DRG"}],"standard_charges":[{"minimum":17179,"maximum":17179,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17179,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERIPHERAL AND OTHER VASCULAR DISORDERS","code_information":[{"code":"1973","type":"APR-DRG"}],"standard_charges":[{"minimum":18709,"maximum":18709,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18709,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERIPHERAL AND OTHER VASCULAR DISORDERS","code_information":[{"code":"1974","type":"APR-DRG"}],"standard_charges":[{"minimum":54467,"maximum":54467,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":54467,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS","code_information":[{"code":"1981","type":"APR-DRG"}],"standard_charges":[{"minimum":9670,"maximum":9670,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9670,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS","code_information":[{"code":"1982","type":"APR-DRG"}],"standard_charges":[{"minimum":11557,"maximum":11557,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11557,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS","code_information":[{"code":"1983","type":"APR-DRG"}],"standard_charges":[{"minimum":18025,"maximum":18025,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18025,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STAPLER INT LIN TA 60-3.5MM","code_information":[{"code":"198340","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":241.63,"maximum":317.76,"gross_charge":331,"discounted_cash":191.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":314.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":317.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":241.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":274.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":241.63,"methodology":"fee schedule"}]}]},{"description":"STAPLER INT LIN TA 60-3.5MM","code_information":[{"code":"198340","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":105.92,"maximum":317.76,"gross_charge":331,"discounted_cash":191.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":314.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":317.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":241.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":274.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":241.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":114.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":105.92,"methodology":"fee schedule"}]}]},{"description":"ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS","code_information":[{"code":"1984","type":"APR-DRG"}],"standard_charges":[{"minimum":33517,"maximum":33517,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33517,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HYPERTENSION","code_information":[{"code":"1991","type":"APR-DRG"}],"standard_charges":[{"minimum":10009,"maximum":10009,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10009,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HYPERTENSION","code_information":[{"code":"1992","type":"APR-DRG"}],"standard_charges":[{"minimum":11944,"maximum":11944,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11944,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HYPERTENSION","code_information":[{"code":"1993","type":"APR-DRG"}],"standard_charges":[{"minimum":14429,"maximum":14429,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14429,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HYPERTENSION","code_information":[{"code":"1994","type":"APR-DRG"}],"standard_charges":[{"minimum":32069,"maximum":32069,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32069,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTRD LAPSCP MPLR L-HK","code_information":[{"code":"199451","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":346.75,"maximum":456,"gross_charge":475,"discounted_cash":275.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":451.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":456,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":346.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":394.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":346.75,"methodology":"fee schedule"}]}]},{"description":"ELECTRD LAPSCP MPLR L-HK","code_information":[{"code":"199451","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":456,"gross_charge":475,"discounted_cash":275.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":451.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":456,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":346.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":394.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":346.75,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":228,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":164.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":152,"methodology":"fee schedule"}]}]},{"description":"CARDIAC STRUCTURAL AND VALVULAR DISORDERS","code_information":[{"code":"2001","type":"APR-DRG"}],"standard_charges":[{"minimum":11031,"maximum":11031,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11031,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC STRUCTURAL AND VALVULAR DISORDERS","code_information":[{"code":"2002","type":"APR-DRG"}],"standard_charges":[{"minimum":22133,"maximum":22133,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22133,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC STRUCTURAL AND VALVULAR DISORDERS","code_information":[{"code":"2003","type":"APR-DRG"}],"standard_charges":[{"minimum":22870,"maximum":22870,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22870,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SYR 60ML ANGIO F/MAXFORC BLLN","code_information":[{"code":"200358","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":91.25,"maximum":120,"gross_charge":125,"discounted_cash":72.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":118.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":120,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":91.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":103.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":91.25,"methodology":"fee schedule"}]}]},{"description":"SYR 60ML ANGIO F/MAXFORC BLLN","code_information":[{"code":"200358","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":40,"maximum":120,"gross_charge":125,"discounted_cash":72.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":118.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":120,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":91.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":103.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":91.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":60,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":43.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":40,"methodology":"fee schedule"}]}]},{"description":"CARDIAC STRUCTURAL AND VALVULAR DISORDERS","code_information":[{"code":"2004","type":"APR-DRG"}],"standard_charges":[{"minimum":46076,"maximum":46076,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46076,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS","code_information":[{"code":"2011","type":"APR-DRG"}],"standard_charges":[{"minimum":11759,"maximum":11759,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11759,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS","code_information":[{"code":"2012","type":"APR-DRG"}],"standard_charges":[{"minimum":12870,"maximum":12870,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12870,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS","code_information":[{"code":"2013","type":"APR-DRG"}],"standard_charges":[{"minimum":20288,"maximum":20288,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20288,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS","code_information":[{"code":"2014","type":"APR-DRG"}],"standard_charges":[{"minimum":58557,"maximum":58557,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":58557,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PROC TY THORCENT 8FRX18CM","code_information":[{"code":"202554","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":160.6,"maximum":211.2,"gross_charge":220,"discounted_cash":127.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":209,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":160.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":182.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":160.6,"methodology":"fee schedule"}]}]},{"description":"PROC TY THORCENT 8FRX18CM","code_information":[{"code":"202554","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":70.4,"maximum":211.2,"gross_charge":220,"discounted_cash":127.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":209,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":160.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":182.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":160.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":105.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":76.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":70.4,"methodology":"fee schedule"}]}]},{"description":"CHEST PAIN","code_information":[{"code":"2031","type":"APR-DRG"}],"standard_charges":[{"minimum":10081,"maximum":10081,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10081,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHEST PAIN","code_information":[{"code":"2032","type":"APR-DRG"}],"standard_charges":[{"minimum":11903,"maximum":11903,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11903,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHEST PAIN","code_information":[{"code":"2033","type":"APR-DRG"}],"standard_charges":[{"minimum":17227,"maximum":17227,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17227,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHEST PAIN","code_information":[{"code":"2034","type":"APR-DRG"}],"standard_charges":[{"minimum":27121,"maximum":27121,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27121,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SOL ORAL VARIBAR PSTE HNY","code_information":[{"code":"203781","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":131.35,"maximum":172.73,"gross_charge":179.92,"discounted_cash":104.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":170.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":172.73,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":131.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":149.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":131.35,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL VARIBAR PSTE HNY","code_information":[{"code":"203781","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":57.58,"maximum":172.73,"gross_charge":179.92,"discounted_cash":104.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":170.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":172.73,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":131.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":149.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":131.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":62.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":57.58,"methodology":"fee schedule"}]}]},{"description":"SYNCOPE AND COLLAPSE","code_information":[{"code":"2041","type":"APR-DRG"}],"standard_charges":[{"minimum":15279,"maximum":15279,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15279,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SYNCOPE AND COLLAPSE","code_information":[{"code":"2042","type":"APR-DRG"}],"standard_charges":[{"minimum":15514,"maximum":15514,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15514,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SYNCOPE AND COLLAPSE","code_information":[{"code":"2043","type":"APR-DRG"}],"standard_charges":[{"minimum":24705,"maximum":24705,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24705,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SYNCOPE AND COLLAPSE","code_information":[{"code":"2044","type":"APR-DRG"}],"standard_charges":[{"minimum":35545,"maximum":35545,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":35545,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BIT DRL QC AO 2.7X125MM","code_information":[{"code":"204423","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":286.16,"maximum":376.32,"gross_charge":392,"discounted_cash":227.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":372.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":376.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":286.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":286.16,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC AO 2.7X125MM","code_information":[{"code":"204423","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":125.44,"maximum":376.32,"gross_charge":392,"discounted_cash":227.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":372.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":376.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":286.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":325.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":286.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":188.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":135.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":125.44,"methodology":"fee schedule"}]}]},{"description":"CARDIOMYOPATHY","code_information":[{"code":"2051","type":"APR-DRG"}],"standard_charges":[{"minimum":12820,"maximum":12820,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12820,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIOMYOPATHY","code_information":[{"code":"2052","type":"APR-DRG"}],"standard_charges":[{"minimum":15590,"maximum":15590,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15590,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIOMYOPATHY","code_information":[{"code":"2053","type":"APR-DRG"}],"standard_charges":[{"minimum":24731,"maximum":24731,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24731,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CARDIOMYOPATHY","code_information":[{"code":"2054","type":"APR-DRG"}],"standard_charges":[{"minimum":42497,"maximum":42497,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":42497,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ASP.INJ SMALL JOINT","code_information":[{"code":"20600","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":620.5,"maximum":816,"gross_charge":850,"discounted_cash":493,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":807.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":816,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":620.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":705.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":620.5,"methodology":"fee schedule"}]}]},{"description":"ASP.INJ SMALL JOINT","code_information":[{"code":"20600","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":272,"maximum":816,"gross_charge":850,"discounted_cash":493,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":807.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":816,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":620.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":705.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":620.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":408,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":294.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":272,"methodology":"fee schedule"}]}]},{"description":"ASP/INJ MED JOINT INJ","code_information":[{"code":"20605","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":620.5,"maximum":816,"gross_charge":850,"discounted_cash":493,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":807.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":816,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":620.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":705.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":620.5,"methodology":"fee schedule"}]}]},{"description":"ASP/INJ MED JOINT INJ","code_information":[{"code":"20605","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":272,"maximum":816,"gross_charge":850,"discounted_cash":493,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":807.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":816,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":620.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":705.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":620.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":408,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":294.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":272,"methodology":"fee schedule"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE","code_information":[{"code":"2061","type":"APR-DRG"}],"standard_charges":[{"minimum":16429,"maximum":16429,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16429,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJ JOINT INJ","code_information":[{"code":"20610","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":673.06,"maximum":885.12,"gross_charge":922,"discounted_cash":534.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":875.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":885.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":673.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":765.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":673.06,"methodology":"fee schedule"}]}]},{"description":"MAJ JOINT INJ","code_information":[{"code":"20610","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":295.04,"maximum":885.12,"gross_charge":922,"discounted_cash":534.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":875.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":885.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":673.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":765.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":673.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":442.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":319.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":295.04,"methodology":"fee schedule"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE","code_information":[{"code":"2062","type":"APR-DRG"}],"standard_charges":[{"minimum":17986,"maximum":17986,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17986,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE","code_information":[{"code":"2063","type":"APR-DRG"}],"standard_charges":[{"minimum":28623,"maximum":28623,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28623,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE","code_information":[{"code":"2064","type":"APR-DRG"}],"standard_charges":[{"minimum":71783,"maximum":71783,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":71783,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CIRCULATORY SYSTEM DIAGNOSES","code_information":[{"code":"2071","type":"APR-DRG"}],"standard_charges":[{"minimum":13051,"maximum":13051,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13051,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CIRCULATORY SYSTEM DIAGNOSES","code_information":[{"code":"2072","type":"APR-DRG"}],"standard_charges":[{"minimum":14196,"maximum":14196,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14196,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CIRCULATORY SYSTEM DIAGNOSES","code_information":[{"code":"2073","type":"APR-DRG"}],"standard_charges":[{"minimum":17129,"maximum":17129,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17129,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CIRCULATORY SYSTEM DIAGNOSES","code_information":[{"code":"2074","type":"APR-DRG"}],"standard_charges":[{"minimum":46119,"maximum":46119,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46119,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"APPLIER LIG MCA LG 13.25IN","code_information":[{"code":"207845","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":133.59,"maximum":175.68,"gross_charge":183,"discounted_cash":106.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":173.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":175.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":133.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":151.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":133.59,"methodology":"fee schedule"}]}]},{"description":"APPLIER LIG MCA LG 13.25IN","code_information":[{"code":"207845","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":58.56,"maximum":175.68,"gross_charge":183,"discounted_cash":106.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":173.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":175.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":133.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":151.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":133.59,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":87.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":63.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":58.56,"methodology":"fee schedule"}]}]},{"description":"CATH ESOPH CRE 15-18MMX8CM 6FR","code_information":[{"code":"207935","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":400.04,"maximum":526.08,"gross_charge":548,"discounted_cash":317.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":520.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":526.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":400.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":454.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":400.04,"methodology":"fee schedule"}]}]},{"description":"CATH ESOPH CRE 15-18MMX8CM 6FR","code_information":[{"code":"207935","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":175.36,"maximum":526.08,"gross_charge":548,"discounted_cash":317.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":520.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":526.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":400.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":454.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":400.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":263.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":190.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":175.36,"methodology":"fee schedule"}]}]},{"description":"CNTNR EMP EVAC VAC 1000ML BTL","code_information":[{"code":"208240","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":62.38,"maximum":82.03,"gross_charge":85.44,"discounted_cash":49.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":81.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":82.03,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":62.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":70.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":62.38,"methodology":"fee schedule"}]}]},{"description":"CNTNR EMP EVAC VAC 1000ML BTL","code_information":[{"code":"208240","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":27.35,"maximum":82.03,"gross_charge":85.44,"discounted_cash":49.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":81.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":82.03,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":62.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":70.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":62.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":41.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":29.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":27.35,"methodology":"fee schedule"}]}]},{"description":"CABLE SPNE SGL-LD CRMP 1.0X470","code_information":[{"code":"210692","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":557.72,"maximum":733.44,"gross_charge":764,"discounted_cash":443.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":725.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":733.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":557.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":634.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":557.72,"methodology":"fee schedule"}]}]},{"description":"CABLE SPNE SGL-LD CRMP 1.0X470","code_information":[{"code":"210692","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":244.48,"maximum":733.44,"gross_charge":764,"discounted_cash":443.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":725.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":733.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":557.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":634.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":557.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":366.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":264.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":244.48,"methodology":"fee schedule"}]}]},{"description":"FRCP BCOCK 10MMX39.7CM X1","code_information":[{"code":"214256","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":197.1,"maximum":259.2,"gross_charge":270,"discounted_cash":156.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":256.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":259.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":197.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":224.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":197.1,"methodology":"fee schedule"}]}]},{"description":"FRCP BCOCK 10MMX39.7CM X1","code_information":[{"code":"214256","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":86.4,"maximum":259.2,"gross_charge":270,"discounted_cash":156.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":256.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":259.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":197.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":224.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":197.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":129.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":93.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":86.4,"methodology":"fee schedule"}]}]},{"description":"BAG DRNGE URIN VLV IC 2000MLX1","code_information":[{"code":"216014","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":10.95,"maximum":14.4,"gross_charge":15,"discounted_cash":8.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":14.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":14.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":10.95,"methodology":"fee schedule"}]}]},{"description":"BAG DRNGE URIN VLV IC 2000MLX1","code_information":[{"code":"216014","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":4.8,"maximum":14.4,"gross_charge":15,"discounted_cash":8.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":14.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":14.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":12.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":10.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":7.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":5.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":4.8,"methodology":"fee schedule"}]}]},{"description":"BIT DRL STP 2.5X12 NS","code_information":[{"code":"216424","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":446.03,"maximum":586.56,"gross_charge":611,"discounted_cash":354.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":580.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":586.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":446.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":507.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":446.03,"methodology":"fee schedule"}]}]},{"description":"BIT DRL STP 2.5X12 NS","code_information":[{"code":"216424","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":195.52,"maximum":586.56,"gross_charge":611,"discounted_cash":354.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":580.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":586.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":446.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":507.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":446.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":293.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":211.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":195.52,"methodology":"fee schedule"}]}]},{"description":"STAPLER GIA 80MM-3.8MM","code_information":[{"code":"216449","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":343.1,"maximum":451.2,"gross_charge":470,"discounted_cash":272.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":446.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":451.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":343.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":390.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":343.1,"methodology":"fee schedule"}]}]},{"description":"STAPLER GIA 80MM-3.8MM","code_information":[{"code":"216449","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":150.4,"maximum":451.2,"gross_charge":470,"discounted_cash":272.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":446.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":451.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":343.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":390.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":343.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":225.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":163,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":150.4,"methodology":"fee schedule"}]}]},{"description":"WAND COBLATOR EVAC 70 XTRA","code_information":[{"code":"217135","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":523.41,"maximum":688.32,"gross_charge":717,"discounted_cash":415.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":681.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":688.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":523.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":595.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":523.41,"methodology":"fee schedule"}]}]},{"description":"WAND COBLATOR EVAC 70 XTRA","code_information":[{"code":"217135","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":229.44,"maximum":688.32,"gross_charge":717,"discounted_cash":415.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":681.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":688.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":523.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":595.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":523.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":344.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":248.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":229.44,"methodology":"fee schedule"}]}]},{"description":"SET 20GX1 MINI LOC INFUS","code_information":[{"code":"217312","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":24.09,"maximum":31.68,"gross_charge":33,"discounted_cash":19.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":31.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":31.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":24.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":24.09,"methodology":"fee schedule"}]}]},{"description":"SET 20GX1 MINI LOC INFUS","code_information":[{"code":"217312","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":10.56,"maximum":31.68,"gross_charge":33,"discounted_cash":19.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":31.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":31.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":24.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":24.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":11.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":10.56,"methodology":"fee schedule"}]}]},{"description":"FRCP BX RAD JAW 4 W/NDLEA1/BX2","code_information":[{"code":"217534","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":110.96,"maximum":145.92,"gross_charge":152,"discounted_cash":88.16,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":144.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":145.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":110.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":110.96,"methodology":"fee schedule"}]}]},{"description":"FRCP BX RAD JAW 4 W/NDLEA1/BX2","code_information":[{"code":"217534","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":48.64,"maximum":145.92,"gross_charge":152,"discounted_cash":88.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":144.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":145.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":110.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":110.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":72.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":52.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":48.64,"methodology":"fee schedule"}]}]},{"description":"FRCP BX HOT RAD 3 3MMX240CM","code_information":[{"code":"218056","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":56.94,"maximum":74.88,"gross_charge":78,"discounted_cash":45.24,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":74.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":74.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":56.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":64.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":56.94,"methodology":"fee schedule"}]}]},{"description":"FRCP BX HOT RAD 3 3MMX240CM","code_information":[{"code":"218056","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":24.96,"maximum":74.88,"gross_charge":78,"discounted_cash":45.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":74.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":74.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":56.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":64.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":56.94,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":37.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":27.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":24.96,"methodology":"fee schedule"}]}]},{"description":"INTRO SET MIC UNIV 5FR","code_information":[{"code":"218127","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":76.65,"maximum":100.8,"gross_charge":105,"discounted_cash":60.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":99.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":100.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":76.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":87.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":76.65,"methodology":"fee schedule"}]}]},{"description":"INTRO SET MIC UNIV 5FR","code_information":[{"code":"218127","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":33.6,"maximum":100.8,"gross_charge":105,"discounted_cash":60.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":99.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":100.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":76.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":87.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":76.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":50.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":36.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":33.6,"methodology":"fee schedule"}]}]},{"description":"MAJOR STOMACH ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2201","type":"APR-DRG"}],"standard_charges":[{"minimum":20370,"maximum":20370,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20370,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR STOMACH ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2202","type":"APR-DRG"}],"standard_charges":[{"minimum":35095,"maximum":35095,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":35095,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR STOMACH ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2203","type":"APR-DRG"}],"standard_charges":[{"minimum":62620,"maximum":62620,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":62620,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR STOMACH ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2204","type":"APR-DRG"}],"standard_charges":[{"minimum":103078,"maximum":103078,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":103078,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER STOMACH ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2221","type":"APR-DRG"}],"standard_charges":[{"minimum":15864,"maximum":15864,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15864,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER STOMACH ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2222","type":"APR-DRG"}],"standard_charges":[{"minimum":29290,"maximum":29290,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29290,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER STOMACH ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2223","type":"APR-DRG"}],"standard_charges":[{"minimum":48641,"maximum":48641,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48641,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER STOMACH ESOPHAGEAL AND DUODENAL PROCEDURES","code_information":[{"code":"2224","type":"APR-DRG"}],"standard_charges":[{"minimum":105006,"maximum":105006,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":105006,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRCR ENDOSCP 5X100MM X2","code_information":[{"code":"222972","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":102.93,"maximum":135.36,"gross_charge":141,"discounted_cash":81.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":133.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":135.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":102.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":117.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":102.93,"methodology":"fee schedule"}]}]},{"description":"TRCR ENDOSCP 5X100MM X2","code_information":[{"code":"222972","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":45.12,"maximum":135.36,"gross_charge":141,"discounted_cash":81.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":133.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":135.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":102.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":117.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":102.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":48.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":45.12,"methodology":"fee schedule"}]}]},{"description":"OTHER SMALL AND LARGE BOWEL PROCEDURES","code_information":[{"code":"2231","type":"APR-DRG"}],"standard_charges":[{"minimum":23516,"maximum":23516,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23516,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER SMALL AND LARGE BOWEL PROCEDURES","code_information":[{"code":"2232","type":"APR-DRG"}],"standard_charges":[{"minimum":27775,"maximum":27775,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27775,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER SMALL AND LARGE BOWEL PROCEDURES","code_information":[{"code":"2233","type":"APR-DRG"}],"standard_charges":[{"minimum":57311,"maximum":57311,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":57311,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER SMALL AND LARGE BOWEL PROCEDURES","code_information":[{"code":"2234","type":"APR-DRG"}],"standard_charges":[{"minimum":100924,"maximum":100924,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":100924,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRCR ENDO 12X100MM BLDELESS","code_information":[{"code":"224077","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":142.35,"maximum":187.2,"gross_charge":195,"discounted_cash":113.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":185.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":187.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":142.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":161.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":142.35,"methodology":"fee schedule"}]}]},{"description":"TRCR ENDO 12X100MM BLDELESS","code_information":[{"code":"224077","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":62.4,"maximum":187.2,"gross_charge":195,"discounted_cash":113.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":185.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":187.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":142.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":161.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":142.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":67.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":62.4,"methodology":"fee schedule"}]}]},{"description":"PERITONEAL ADHESIOLYSIS","code_information":[{"code":"2241","type":"APR-DRG"}],"standard_charges":[{"minimum":24475,"maximum":24475,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24475,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CANN ENDOPATH EXCEL STBL SLV","code_information":[{"code":"224156","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":82.49,"maximum":108.48,"gross_charge":113,"discounted_cash":65.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":107.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":108.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":82.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":93.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":82.49,"methodology":"fee schedule"}]}]},{"description":"CANN ENDOPATH EXCEL STBL SLV","code_information":[{"code":"224156","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":36.16,"maximum":108.48,"gross_charge":113,"discounted_cash":65.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":107.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":108.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":82.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":93.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":82.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":54.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":39.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":36.16,"methodology":"fee schedule"}]}]},{"description":"CANN ENDOPATH EXCEL SLV","code_information":[{"code":"224157","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":59.86,"maximum":78.72,"gross_charge":82,"discounted_cash":47.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":77.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":78.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":59.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":59.86,"methodology":"fee schedule"}]}]},{"description":"CANN ENDOPATH EXCEL SLV","code_information":[{"code":"224157","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":26.24,"maximum":78.72,"gross_charge":82,"discounted_cash":47.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":77.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":78.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":59.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":59.86,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":28.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":26.24,"methodology":"fee schedule"}]}]},{"description":"PERITONEAL ADHESIOLYSIS","code_information":[{"code":"2242","type":"APR-DRG"}],"standard_charges":[{"minimum":30264,"maximum":30264,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30264,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERITONEAL ADHESIOLYSIS","code_information":[{"code":"2243","type":"APR-DRG"}],"standard_charges":[{"minimum":34741,"maximum":34741,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34741,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PERITONEAL ADHESIOLYSIS","code_information":[{"code":"2244","type":"APR-DRG"}],"standard_charges":[{"minimum":96169,"maximum":96169,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":96169,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TB SALEM SUMP VLV 12FR","code_information":[{"code":"225572","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":14,"maximum":18.41,"gross_charge":19.17,"discounted_cash":11.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":18.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":18.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":14,"methodology":"fee schedule"}]}]},{"description":"TB SALEM SUMP VLV 12FR","code_information":[{"code":"225572","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":6.14,"maximum":18.41,"gross_charge":19.17,"discounted_cash":11.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":18.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":18.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":15.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":9.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":6.14,"methodology":"fee schedule"}]}]},{"description":"CATH KT MULTI LUMEN STRL 7FR 8","code_information":[{"code":"225839","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":256.96,"maximum":337.92,"gross_charge":352,"discounted_cash":204.16,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":334.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":337.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":256.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":292.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":256.96,"methodology":"fee schedule"}]}]},{"description":"CATH KT MULTI LUMEN STRL 7FR 8","code_information":[{"code":"225839","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":112.64,"maximum":337.92,"gross_charge":352,"discounted_cash":204.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":334.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":337.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":256.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":292.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":256.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":168.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":122.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":112.64,"methodology":"fee schedule"}]}]},{"description":"ANAL PROCEDURES","code_information":[{"code":"2261","type":"APR-DRG"}],"standard_charges":[{"minimum":20812,"maximum":20812,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20812,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LUMBAR SPINE FUSION","code_information":[{"code":"22612","type":"CPT"}],"standard_charges":[{"minimum":13521.32,"maximum":13521.32,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13521.32,"methodology":"fee schedule"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_percentage":48,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_percentage":34.68,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_percentage":32,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ANAL PROCEDURES","code_information":[{"code":"2262","type":"APR-DRG"}],"standard_charges":[{"minimum":25714,"maximum":25714,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25714,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANAL PROCEDURES","code_information":[{"code":"2263","type":"APR-DRG"}],"standard_charges":[{"minimum":41932,"maximum":41932,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41932,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANAL PROCEDURES","code_information":[{"code":"2264","type":"APR-DRG"}],"standard_charges":[{"minimum":69914,"maximum":69914,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":69914,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BINDER ABD 4PNL 2XL 12X72-84IN","code_information":[{"code":"226731","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":29.93,"maximum":39.36,"gross_charge":41,"discounted_cash":23.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.93,"methodology":"fee schedule"}]}]},{"description":"BINDER ABD 4PNL 2XL 12X72-84IN","code_information":[{"code":"226731","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":13.12,"maximum":39.36,"gross_charge":41,"discounted_cash":23.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.12,"methodology":"fee schedule"}]}]},{"description":"BLDE SHV CUT AGR FORM 4MM STRL","code_information":[{"code":"226948","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":135.05,"maximum":177.6,"gross_charge":185,"discounted_cash":107.3,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":175.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":177.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":153.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":135.05,"methodology":"fee schedule"}]}]},{"description":"BLDE SHV CUT AGR FORM 4MM STRL","code_information":[{"code":"226948","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":59.2,"maximum":177.6,"gross_charge":185,"discounted_cash":107.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":175.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":177.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":153.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":135.05,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":88.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":64.16,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":59.2,"methodology":"fee schedule"}]}]},{"description":"HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL AND UMBILICAL","code_information":[{"code":"2271","type":"APR-DRG"}],"standard_charges":[{"minimum":24351,"maximum":24351,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24351,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL AND UMBILICAL","code_information":[{"code":"2272","type":"APR-DRG"}],"standard_charges":[{"minimum":24603,"maximum":24603,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24603,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL AND UMBILICAL","code_information":[{"code":"2273","type":"APR-DRG"}],"standard_charges":[{"minimum":44591,"maximum":44591,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44591,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HERNIA PROCEDURES EXCEPT INGUINAL FEMORAL AND UMBILICAL","code_information":[{"code":"2274","type":"APR-DRG"}],"standard_charges":[{"minimum":98789,"maximum":98789,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":98789,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TB CHST KT PLEURA GD INSRT","code_information":[{"code":"227610","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":208.78,"maximum":274.56,"gross_charge":286,"discounted_cash":165.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":271.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":274.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":208.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":237.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":208.78,"methodology":"fee schedule"}]}]},{"description":"TB CHST KT PLEURA GD INSRT","code_information":[{"code":"227610","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":91.52,"maximum":274.56,"gross_charge":286,"discounted_cash":165.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":271.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":274.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":208.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":237.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":208.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":137.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":99.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":91.52,"methodology":"fee schedule"}]}]},{"description":"INGUINAL FEMORAL AND UMBILICAL HERNIA PROCEDURES","code_information":[{"code":"2281","type":"APR-DRG"}],"standard_charges":[{"minimum":24121,"maximum":24121,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24121,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INGUINAL FEMORAL AND UMBILICAL HERNIA PROCEDURES","code_information":[{"code":"2282","type":"APR-DRG"}],"standard_charges":[{"minimum":31103,"maximum":31103,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31103,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INGUINAL FEMORAL AND UMBILICAL HERNIA PROCEDURES","code_information":[{"code":"2283","type":"APR-DRG"}],"standard_charges":[{"minimum":34441,"maximum":34441,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34441,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INGUINAL FEMORAL AND UMBILICAL HERNIA PROCEDURES","code_information":[{"code":"2284","type":"APR-DRG"}],"standard_charges":[{"minimum":70398,"maximum":70398,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":70398,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CERV ARTIFIC DISKECTOMY","code_information":[{"code":"22856","type":"CPT"}],"standard_charges":[{"minimum":17756.28,"maximum":17756.28,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17756.28,"methodology":"fee schedule"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_percentage":48,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_percentage":34.68,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_percentage":32,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"STAT LOCK 2WAY CATH","code_information":[{"code":"228693","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":12.4,"maximum":16.31,"gross_charge":16.98,"discounted_cash":9.85,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":16.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":16.31,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":12.4,"methodology":"fee schedule"}]}]},{"description":"STAT LOCK 2WAY CATH","code_information":[{"code":"228693","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":5.44,"maximum":16.31,"gross_charge":16.98,"discounted_cash":9.85,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":16.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":16.31,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":12.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":12.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":8.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":5.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.44,"methodology":"fee schedule"}]}]},{"description":"OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES","code_information":[{"code":"2291","type":"APR-DRG"}],"standard_charges":[{"minimum":20564,"maximum":20564,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20564,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES","code_information":[{"code":"2292","type":"APR-DRG"}],"standard_charges":[{"minimum":24490,"maximum":24490,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24490,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES","code_information":[{"code":"2293","type":"APR-DRG"}],"standard_charges":[{"minimum":54493,"maximum":54493,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":54493,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES","code_information":[{"code":"2294","type":"APR-DRG"}],"standard_charges":[{"minimum":117794,"maximum":117794,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":117794,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR SMALL BOWEL PROCEDURES","code_information":[{"code":"2301","type":"APR-DRG"}],"standard_charges":[{"minimum":26658,"maximum":26658,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26658,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"APPLIER CLP LIG 5MM","code_information":[{"code":"230105","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":309.52,"maximum":407.04,"gross_charge":424,"discounted_cash":245.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":402.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":407.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":309.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":351.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":309.52,"methodology":"fee schedule"}]}]},{"description":"APPLIER CLP LIG 5MM","code_information":[{"code":"230105","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":135.68,"maximum":407.04,"gross_charge":424,"discounted_cash":245.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":402.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":407.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":309.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":351.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":309.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":203.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":147.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":135.68,"methodology":"fee schedule"}]}]},{"description":"MAJOR SMALL BOWEL PROCEDURES","code_information":[{"code":"2302","type":"APR-DRG"}],"standard_charges":[{"minimum":37141,"maximum":37141,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37141,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR SMALL BOWEL PROCEDURES","code_information":[{"code":"2303","type":"APR-DRG"}],"standard_charges":[{"minimum":55894,"maximum":55894,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":55894,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR SMALL BOWEL PROCEDURES","code_information":[{"code":"2304","type":"APR-DRG"}],"standard_charges":[{"minimum":135425,"maximum":135425,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":135425,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STPLR CUTTER CNTR CURVED","code_information":[{"code":"230744","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":783.29,"maximum":1030.08,"gross_charge":1073,"discounted_cash":622.34,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1019.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1030.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":783.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":890.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":783.29,"methodology":"fee schedule"}]}]},{"description":"STPLR CUTTER CNTR CURVED","code_information":[{"code":"230744","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":343.36,"maximum":1030.08,"gross_charge":1073,"discounted_cash":622.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1019.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1030.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":783.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":890.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":783.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":515.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":372.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":343.36,"methodology":"fee schedule"}]}]},{"description":"PRISMA MATRIX 4.34IN SQR","code_information":[{"code":"230746","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":30.53,"maximum":40.14,"gross_charge":41.81,"discounted_cash":24.25,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":39.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":40.14,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":30.53,"methodology":"fee schedule"}]}]},{"description":"PRISMA MATRIX 4.34IN SQR","code_information":[{"code":"230746","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":13.38,"maximum":40.14,"gross_charge":41.81,"discounted_cash":24.25,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":39.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":40.14,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":30.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":20.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.38,"methodology":"fee schedule"}]}]},{"description":"TRCR ENDOPATH XCEL 12X100MM","code_information":[{"code":"230953","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":183.23,"maximum":240.96,"gross_charge":251,"discounted_cash":145.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":238.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":240.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":183.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":183.23,"methodology":"fee schedule"}]}]},{"description":"TRCR ENDOPATH XCEL 12X100MM","code_information":[{"code":"230953","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":80.32,"maximum":240.96,"gross_charge":251,"discounted_cash":145.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":238.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":240.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":183.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":208.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":183.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":120.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":87.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":80.32,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL + 4-0 27IN BRD UD X2","code_information":[{"code":"230961","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":9.01,"maximum":11.85,"gross_charge":12.34,"discounted_cash":7.16,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11.85,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":9.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":9.01,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL + 4-0 27IN BRD UD X2","code_information":[{"code":"230961","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":3.95,"maximum":11.85,"gross_charge":12.34,"discounted_cash":7.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11.85,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":9.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":9.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":4.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3.95,"methodology":"fee schedule"}]}]},{"description":"MAJOR LARGE BOWEL PROCEDURES","code_information":[{"code":"2311","type":"APR-DRG"}],"standard_charges":[{"minimum":30682,"maximum":30682,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30682,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR LARGE BOWEL PROCEDURES","code_information":[{"code":"2312","type":"APR-DRG"}],"standard_charges":[{"minimum":35451,"maximum":35451,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":35451,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR LARGE BOWEL PROCEDURES","code_information":[{"code":"2313","type":"APR-DRG"}],"standard_charges":[{"minimum":50015,"maximum":50015,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50015,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR LARGE BOWEL PROCEDURES","code_information":[{"code":"2314","type":"APR-DRG"}],"standard_charges":[{"minimum":63724,"maximum":63724,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":63724,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH KT MULTI-LUMEN 7FR 20CM","code_information":[{"code":"231562","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":167.17,"maximum":219.84,"gross_charge":229,"discounted_cash":132.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":217.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":219.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":167.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":190.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":167.17,"methodology":"fee schedule"}]}]},{"description":"CATH KT MULTI-LUMEN 7FR 20CM","code_information":[{"code":"231562","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":73.28,"maximum":219.84,"gross_charge":229,"discounted_cash":132.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":217.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":219.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":167.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":190.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":167.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":79.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":73.28,"methodology":"fee schedule"}]}]},{"description":"BINDER ABD 3PNL UNIV 9X30-45IN","code_information":[{"code":"231613","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":23.36,"maximum":30.72,"gross_charge":32,"discounted_cash":18.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":30.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":30.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":23.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":23.36,"methodology":"fee schedule"}]}]},{"description":"BINDER ABD 3PNL UNIV 9X30-45IN","code_information":[{"code":"231613","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":10.24,"maximum":30.72,"gross_charge":32,"discounted_cash":18.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":30.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":30.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":23.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":23.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":11.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":10.24,"methodology":"fee schedule"}]}]},{"description":"GASTRIC FUNDOPLICATION","code_information":[{"code":"2321","type":"APR-DRG"}],"standard_charges":[{"minimum":19514,"maximum":19514,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19514,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BARIUM LIQUID E-Z PAQUE 12OZ","code_information":[{"code":"232170","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":7.3,"maximum":9.6,"gross_charge":10,"discounted_cash":5.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":9.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":9.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7.3,"methodology":"fee schedule"}]}]},{"description":"BARIUM LIQUID E-Z PAQUE 12OZ","code_information":[{"code":"232170","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":3.2,"maximum":9.6,"gross_charge":10,"discounted_cash":5.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":9.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":9.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3.2,"methodology":"fee schedule"}]}]},{"description":"GASTRIC FUNDOPLICATION","code_information":[{"code":"2322","type":"APR-DRG"}],"standard_charges":[{"minimum":36286,"maximum":36286,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36286,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"GASTRIC FUNDOPLICATION","code_information":[{"code":"2323","type":"APR-DRG"}],"standard_charges":[{"minimum":47963,"maximum":47963,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":47963,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"GASTRIC FUNDOPLICATION","code_information":[{"code":"2324","type":"APR-DRG"}],"standard_charges":[{"minimum":105256,"maximum":105256,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":105256,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2331","type":"APR-DRG"}],"standard_charges":[{"minimum":21829,"maximum":21829,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21829,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2332","type":"APR-DRG"}],"standard_charges":[{"minimum":27592,"maximum":27592,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27592,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2333","type":"APR-DRG"}],"standard_charges":[{"minimum":38806,"maximum":38806,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38806,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2334","type":"APR-DRG"}],"standard_charges":[{"minimum":74362,"maximum":74362,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":74362,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRANSCONN 25.5-30.5MM","code_information":[{"code":"233554","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":756.28,"maximum":994.56,"gross_charge":1036,"discounted_cash":600.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":984.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":994.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":756.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":859.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":756.28,"methodology":"fee schedule"}]}]},{"description":"TRANSCONN 25.5-30.5MM","code_information":[{"code":"233554","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":331.52,"maximum":994.56,"gross_charge":1036,"discounted_cash":600.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":984.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":994.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":756.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":859.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":756.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":497.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":359.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":331.52,"methodology":"fee schedule"}]}]},{"description":"HOOK TRNVRS PROC CLCK-X R TI","code_information":[{"code":"233557","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1035.14,"maximum":1361.28,"gross_charge":1418,"discounted_cash":822.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1347.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1361.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1035.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1176.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1035.14,"methodology":"fee schedule"}]}]},{"description":"HOOK TRNVRS PROC CLCK-X R TI","code_information":[{"code":"233557","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":453.76,"maximum":1361.28,"gross_charge":1418,"discounted_cash":822.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1347.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1361.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1035.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1176.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1035.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":680.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":491.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":453.76,"methodology":"fee schedule"}]}]},{"description":"ELECTRD QUICK COMBO PED","code_information":[{"code":"233983","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":67.89,"maximum":89.28,"gross_charge":93,"discounted_cash":53.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":88.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":89.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":67.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":67.89,"methodology":"fee schedule"}]}]},{"description":"ELECTRD QUICK COMBO PED","code_information":[{"code":"233983","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":29.76,"maximum":89.28,"gross_charge":93,"discounted_cash":53.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":88.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":89.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":67.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":67.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.26,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":29.76,"methodology":"fee schedule"}]}]},{"description":"APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2341","type":"APR-DRG"}],"standard_charges":[{"minimum":21966,"maximum":21966,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21966,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2342","type":"APR-DRG"}],"standard_charges":[{"minimum":24062,"maximum":24062,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24062,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2343","type":"APR-DRG"}],"standard_charges":[{"minimum":37491,"maximum":37491,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37491,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS","code_information":[{"code":"2344","type":"APR-DRG"}],"standard_charges":[{"minimum":69659,"maximum":69659,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":69659,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HANDSWITCH LIGASURE ATLS 37CM","code_information":[{"code":"234420","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":832.2,"maximum":1094.4,"gross_charge":1140,"discounted_cash":661.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1083,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1094.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":832.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":946.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":832.2,"methodology":"fee schedule"}]}]},{"description":"HANDSWITCH LIGASURE ATLS 37CM","code_information":[{"code":"234420","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":364.8,"maximum":1094.4,"gross_charge":1140,"discounted_cash":661.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1083,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1094.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":832.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":946.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":832.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":547.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":395.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":364.8,"methodology":"fee schedule"}]}]},{"description":"RECONSTRUCT SHOULDER JOINT","code_information":[{"code":"23472","type":"CPT"}],"standard_charges":[{"minimum":19531.91,"maximum":19531.91,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19531.91,"methodology":"fee schedule"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_percentage":48,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_percentage":34.68,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_percentage":32,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CREAM SENSI-CARE BODY LV 2","code_information":[{"code":"235642","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":10.22,"maximum":13.44,"gross_charge":14,"discounted_cash":8.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":13.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":13.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":10.22,"methodology":"fee schedule"}]}]},{"description":"CREAM SENSI-CARE BODY LV 2","code_information":[{"code":"235642","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":4.48,"maximum":13.44,"gross_charge":14,"discounted_cash":8.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":13.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":13.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":10.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":10.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":4.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":4.48,"methodology":"fee schedule"}]}]},{"description":"PUMP/FLUSH ST KANGAROO","code_information":[{"code":"236206","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":21.17,"maximum":27.84,"gross_charge":29,"discounted_cash":16.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":27.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.17,"methodology":"fee schedule"}]}]},{"description":"PUMP/FLUSH ST KANGAROO","code_information":[{"code":"236206","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":9.28,"maximum":27.84,"gross_charge":29,"discounted_cash":16.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":27.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":13.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.28,"methodology":"fee schedule"}]}]},{"description":"SHEARS HARM HS FOCUS CRV 9CM","code_information":[{"code":"236443","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":904.47,"maximum":1189.44,"gross_charge":1239,"discounted_cash":718.62,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1177.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1189.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":904.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1028.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":904.47,"methodology":"fee schedule"}]}]},{"description":"SHEARS HARM HS FOCUS CRV 9CM","code_information":[{"code":"236443","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":396.48,"maximum":1189.44,"gross_charge":1239,"discounted_cash":718.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1177.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1189.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":904.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1028.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":904.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":594.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":429.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":396.48,"methodology":"fee schedule"}]}]},{"description":"BLDE AVERAGE MED","code_information":[{"code":"238786","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":111.69,"maximum":146.88,"gross_charge":153,"discounted_cash":88.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":145.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":146.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":111.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":111.69,"methodology":"fee schedule"}]}]},{"description":"BLDE AVERAGE MED","code_information":[{"code":"238786","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":48.96,"maximum":146.88,"gross_charge":153,"discounted_cash":88.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":145.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":146.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":111.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":111.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":53.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":48.96,"methodology":"fee schedule"}]}]},{"description":"DIGESTIVE MALIGNANCY","code_information":[{"code":"2401","type":"APR-DRG"}],"standard_charges":[{"minimum":18536,"maximum":18536,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18536,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIGESTIVE MALIGNANCY","code_information":[{"code":"2402","type":"APR-DRG"}],"standard_charges":[{"minimum":25553,"maximum":25553,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25553,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIGESTIVE MALIGNANCY","code_information":[{"code":"2403","type":"APR-DRG"}],"standard_charges":[{"minimum":32836,"maximum":32836,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32836,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIGESTIVE MALIGNANCY","code_information":[{"code":"2404","type":"APR-DRG"}],"standard_charges":[{"minimum":52906,"maximum":52906,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":52906,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SOL ORAL VARIBAR THIN 148GM","code_information":[{"code":"240817","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":17.18,"maximum":22.59,"gross_charge":23.53,"discounted_cash":13.65,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":22.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.59,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":17.18,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL VARIBAR THIN 148GM","code_information":[{"code":"240817","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":7.53,"maximum":22.59,"gross_charge":23.53,"discounted_cash":13.65,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":22.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.59,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":17.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":11.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":8.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.53,"methodology":"fee schedule"}]}]},{"description":"PEPTIC ULCER AND GASTRITIS","code_information":[{"code":"2411","type":"APR-DRG"}],"standard_charges":[{"minimum":12524,"maximum":12524,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12524,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PEPTIC ULCER AND GASTRITIS","code_information":[{"code":"2412","type":"APR-DRG"}],"standard_charges":[{"minimum":16792,"maximum":16792,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16792,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PEPTIC ULCER AND GASTRITIS","code_information":[{"code":"2413","type":"APR-DRG"}],"standard_charges":[{"minimum":20055,"maximum":20055,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20055,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PEPTIC ULCER AND GASTRITIS","code_information":[{"code":"2414","type":"APR-DRG"}],"standard_charges":[{"minimum":78825,"maximum":78825,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":78825,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR ESOPHAGEAL DISORDERS","code_information":[{"code":"2421","type":"APR-DRG"}],"standard_charges":[{"minimum":8683,"maximum":8683,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":8683,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR ESOPHAGEAL DISORDERS","code_information":[{"code":"2422","type":"APR-DRG"}],"standard_charges":[{"minimum":11231,"maximum":11231,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11231,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR ESOPHAGEAL DISORDERS","code_information":[{"code":"2423","type":"APR-DRG"}],"standard_charges":[{"minimum":28295,"maximum":28295,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28295,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR ESOPHAGEAL DISORDERS","code_information":[{"code":"2424","type":"APR-DRG"}],"standard_charges":[{"minimum":62889,"maximum":62889,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":62889,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ESOPHAGEAL DISORDERS","code_information":[{"code":"2431","type":"APR-DRG"}],"standard_charges":[{"minimum":14194,"maximum":14194,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14194,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ESOPHAGEAL DISORDERS","code_information":[{"code":"2432","type":"APR-DRG"}],"standard_charges":[{"minimum":19444,"maximum":19444,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19444,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ESOPHAGEAL DISORDERS","code_information":[{"code":"2433","type":"APR-DRG"}],"standard_charges":[{"minimum":28342,"maximum":28342,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28342,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ESOPHAGEAL DISORDERS","code_information":[{"code":"2434","type":"APR-DRG"}],"standard_charges":[{"minimum":41491,"maximum":41491,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41491,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIVERTICULITIS AND DIVERTICULOSIS","code_information":[{"code":"2441","type":"APR-DRG"}],"standard_charges":[{"minimum":11772,"maximum":11772,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11772,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIVERTICULITIS AND DIVERTICULOSIS","code_information":[{"code":"2442","type":"APR-DRG"}],"standard_charges":[{"minimum":15314,"maximum":15314,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15314,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIVERTICULITIS AND DIVERTICULOSIS","code_information":[{"code":"2443","type":"APR-DRG"}],"standard_charges":[{"minimum":20733,"maximum":20733,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20733,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIVERTICULITIS AND DIVERTICULOSIS","code_information":[{"code":"2444","type":"APR-DRG"}],"standard_charges":[{"minimum":44621,"maximum":44621,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44621,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INFLAMMATORY BOWEL DISEASE","code_information":[{"code":"2451","type":"APR-DRG"}],"standard_charges":[{"minimum":12748,"maximum":12748,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12748,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INFLAMMATORY BOWEL DISEASE","code_information":[{"code":"2452","type":"APR-DRG"}],"standard_charges":[{"minimum":15853,"maximum":15853,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15853,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INFLAMMATORY BOWEL DISEASE","code_information":[{"code":"2453","type":"APR-DRG"}],"standard_charges":[{"minimum":24751,"maximum":24751,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24751,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INFLAMMATORY BOWEL DISEASE","code_information":[{"code":"2454","type":"APR-DRG"}],"standard_charges":[{"minimum":36834,"maximum":36834,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36834,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BLDE SAW SAG COARSE 5.5X25.5","code_information":[{"code":"245652","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":180.31,"maximum":237.12,"gross_charge":247,"discounted_cash":143.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":234.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":237.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":180.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":205.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":180.31,"methodology":"fee schedule"}]}]},{"description":"BLDE SAW SAG COARSE 5.5X25.5","code_information":[{"code":"245652","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":79.04,"maximum":237.12,"gross_charge":247,"discounted_cash":143.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":234.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":237.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":180.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":205.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":180.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":118.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":85.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":79.04,"methodology":"fee schedule"}]}]},{"description":"GASTROINTESTINAL VASCULAR INSUFFICIENCY","code_information":[{"code":"2461","type":"APR-DRG"}],"standard_charges":[{"minimum":12409,"maximum":12409,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12409,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"GASTROINTESTINAL VASCULAR INSUFFICIENCY","code_information":[{"code":"2462","type":"APR-DRG"}],"standard_charges":[{"minimum":17818,"maximum":17818,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17818,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"GASTROINTESTINAL VASCULAR INSUFFICIENCY","code_information":[{"code":"2463","type":"APR-DRG"}],"standard_charges":[{"minimum":24723,"maximum":24723,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24723,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"GASTROINTESTINAL VASCULAR INSUFFICIENCY","code_information":[{"code":"2464","type":"APR-DRG"}],"standard_charges":[{"minimum":39706,"maximum":39706,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":39706,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTESTINAL OBSTRUCTION","code_information":[{"code":"2471","type":"APR-DRG"}],"standard_charges":[{"minimum":10303,"maximum":10303,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10303,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KT DRAINAGE PLEURX W/1000 VAC","code_information":[{"code":"247127","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":177.39,"maximum":233.28,"gross_charge":243,"discounted_cash":140.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":230.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":233.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":177.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":201.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":177.39,"methodology":"fee schedule"}]}]},{"description":"KT DRAINAGE PLEURX W/1000 VAC","code_information":[{"code":"247127","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":77.76,"maximum":233.28,"gross_charge":243,"discounted_cash":140.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":230.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":233.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":177.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":201.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":177.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":116.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":84.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":77.76,"methodology":"fee schedule"}]}]},{"description":"INTESTINAL OBSTRUCTION","code_information":[{"code":"2472","type":"APR-DRG"}],"standard_charges":[{"minimum":12564,"maximum":12564,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12564,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTESTINAL OBSTRUCTION","code_information":[{"code":"2473","type":"APR-DRG"}],"standard_charges":[{"minimum":21529,"maximum":21529,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21529,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTESTINAL OBSTRUCTION","code_information":[{"code":"2474","type":"APR-DRG"}],"standard_charges":[{"minimum":38612,"maximum":38612,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38612,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS","code_information":[{"code":"2481","type":"APR-DRG"}],"standard_charges":[{"minimum":11924,"maximum":11924,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11924,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS","code_information":[{"code":"2482","type":"APR-DRG"}],"standard_charges":[{"minimum":16785,"maximum":16785,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16785,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS","code_information":[{"code":"2483","type":"APR-DRG"}],"standard_charges":[{"minimum":24568,"maximum":24568,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24568,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS","code_information":[{"code":"2484","type":"APR-DRG"}],"standard_charges":[{"minimum":73609,"maximum":73609,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":73609,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER GASTROENTERITIS NAUSEA AND VOMITING","code_information":[{"code":"2491","type":"APR-DRG"}],"standard_charges":[{"minimum":9416,"maximum":9416,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9416,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DRSNG INTERDRY 10X12FT","code_information":[{"code":"249135","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":197.83,"maximum":260.16,"gross_charge":271,"discounted_cash":157.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":257.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":260.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":197.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":224.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":197.83,"methodology":"fee schedule"}]}]},{"description":"DRSNG INTERDRY 10X12FT","code_information":[{"code":"249135","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":86.72,"maximum":260.16,"gross_charge":271,"discounted_cash":157.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":257.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":260.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":197.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":224.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":197.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":130.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":93.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":86.72,"methodology":"fee schedule"}]}]},{"description":"OTHER GASTROENTERITIS NAUSEA AND VOMITING","code_information":[{"code":"2492","type":"APR-DRG"}],"standard_charges":[{"minimum":13801,"maximum":13801,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13801,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER GASTROENTERITIS NAUSEA AND VOMITING","code_information":[{"code":"2493","type":"APR-DRG"}],"standard_charges":[{"minimum":27327,"maximum":27327,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27327,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER GASTROENTERITIS NAUSEA AND VOMITING","code_information":[{"code":"2494","type":"APR-DRG"}],"standard_charges":[{"minimum":44891,"maximum":44891,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44891,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABDOMINAL PAIN","code_information":[{"code":"2511","type":"APR-DRG"}],"standard_charges":[{"minimum":14253,"maximum":14253,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14253,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABDOMINAL PAIN","code_information":[{"code":"2512","type":"APR-DRG"}],"standard_charges":[{"minimum":16038,"maximum":16038,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16038,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABDOMINAL PAIN","code_information":[{"code":"2513","type":"APR-DRG"}],"standard_charges":[{"minimum":19525,"maximum":19525,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19525,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABDOMINAL PAIN","code_information":[{"code":"2514","type":"APR-DRG"}],"standard_charges":[{"minimum":34827,"maximum":34827,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34827,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALFUNCTION REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE","code_information":[{"code":"2521","type":"APR-DRG"}],"standard_charges":[{"minimum":10759,"maximum":10759,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10759,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALFUNCTION REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE","code_information":[{"code":"2522","type":"APR-DRG"}],"standard_charges":[{"minimum":20096,"maximum":20096,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20096,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRCR ENDO BLDELSS XLG 12M2","code_information":[{"code":"252229","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":479.61,"maximum":630.72,"gross_charge":657,"discounted_cash":381.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":624.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":630.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":479.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":545.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":479.61,"methodology":"fee schedule"}]}]},{"description":"TRCR ENDO BLDELSS XLG 12M2","code_information":[{"code":"252229","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":210.24,"maximum":630.72,"gross_charge":657,"discounted_cash":381.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":624.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":630.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":479.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":545.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":479.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":315.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":227.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":210.24,"methodology":"fee schedule"}]}]},{"description":"MALFUNCTION REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE","code_information":[{"code":"2523","type":"APR-DRG"}],"standard_charges":[{"minimum":22664,"maximum":22664,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22664,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALFUNCTION REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE","code_information":[{"code":"2524","type":"APR-DRG"}],"standard_charges":[{"minimum":47385,"maximum":47385,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":47385,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE","code_information":[{"code":"2531","type":"APR-DRG"}],"standard_charges":[{"minimum":14051,"maximum":14051,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14051,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE","code_information":[{"code":"2532","type":"APR-DRG"}],"standard_charges":[{"minimum":15235,"maximum":15235,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15235,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TIP INNERVISION 40F","code_information":[{"code":"253213","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":263.53,"maximum":346.56,"gross_charge":361,"discounted_cash":209.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":342.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":346.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":299.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":263.53,"methodology":"fee schedule"}]}]},{"description":"TIP INNERVISION 40F","code_information":[{"code":"253213","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":115.52,"maximum":346.56,"gross_charge":361,"discounted_cash":209.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":342.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":346.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":299.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":173.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":125.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":115.52,"methodology":"fee schedule"}]}]},{"description":"OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE","code_information":[{"code":"2533","type":"APR-DRG"}],"standard_charges":[{"minimum":23951,"maximum":23951,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23951,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE","code_information":[{"code":"2534","type":"APR-DRG"}],"standard_charges":[{"minimum":44815,"maximum":44815,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44815,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DIGESTIVE SYSTEM DIAGNOSES","code_information":[{"code":"2541","type":"APR-DRG"}],"standard_charges":[{"minimum":9116,"maximum":9116,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9116,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DIGESTIVE SYSTEM DIAGNOSES","code_information":[{"code":"2542","type":"APR-DRG"}],"standard_charges":[{"minimum":12642,"maximum":12642,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12642,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DIGESTIVE SYSTEM DIAGNOSES","code_information":[{"code":"2543","type":"APR-DRG"}],"standard_charges":[{"minimum":18064,"maximum":18064,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18064,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DIGESTIVE SYSTEM DIAGNOSES","code_information":[{"code":"2544","type":"APR-DRG"}],"standard_charges":[{"minimum":58811,"maximum":58811,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":58811,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STYLET RFS 6FR 12CM","code_information":[{"code":"258864","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1538.11,"maximum":2022.72,"gross_charge":2107,"discounted_cash":1222.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2001.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2022.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1538.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1748.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1538.11,"methodology":"fee schedule"}]}]},{"description":"STYLET RFS 6FR 12CM","code_information":[{"code":"258864","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":674.24,"maximum":2022.72,"gross_charge":2107,"discounted_cash":1222.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2001.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2022.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1538.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1748.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1538.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1011.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":730.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":674.24,"methodology":"fee schedule"}]}]},{"description":"INTRO SHEATH MICRO 7FR 7CM","code_information":[{"code":"258870","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":94.17,"maximum":123.84,"gross_charge":129,"discounted_cash":74.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":122.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":123.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":94.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":107.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":94.17,"methodology":"fee schedule"}]}]},{"description":"INTRO SHEATH MICRO 7FR 7CM","code_information":[{"code":"258870","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":41.28,"maximum":123.84,"gross_charge":129,"discounted_cash":74.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":122.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":123.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":94.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":107.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":94.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":61.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":44.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":41.28,"methodology":"fee schedule"}]}]},{"description":"MAJOR PANCREAS LIVER AND SHUNT PROCEDURES","code_information":[{"code":"2601","type":"APR-DRG"}],"standard_charges":[{"minimum":31784,"maximum":31784,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31784,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR PANCREAS LIVER AND SHUNT PROCEDURES","code_information":[{"code":"2602","type":"APR-DRG"}],"standard_charges":[{"minimum":40291,"maximum":40291,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":40291,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR PANCREAS LIVER AND SHUNT PROCEDURES","code_information":[{"code":"2603","type":"APR-DRG"}],"standard_charges":[{"minimum":66272,"maximum":66272,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":66272,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR PANCREAS LIVER AND SHUNT PROCEDURES","code_information":[{"code":"2604","type":"APR-DRG"}],"standard_charges":[{"minimum":184294,"maximum":184294,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":184294,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH URETH INTMIT 8FR RED","code_information":[{"code":"260943","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":3.16,"maximum":4.15,"gross_charge":4.32,"discounted_cash":2.51,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4.15,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3.16,"methodology":"fee schedule"}]}]},{"description":"CATH URETH INTMIT 8FR RED","code_information":[{"code":"260943","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1.39,"maximum":4.15,"gross_charge":4.32,"discounted_cash":2.51,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4.15,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1.39,"methodology":"fee schedule"}]}]},{"description":"MAJOR BILIARY TRACT PROCEDURES","code_information":[{"code":"2611","type":"APR-DRG"}],"standard_charges":[{"minimum":40152,"maximum":40152,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":40152,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR BILIARY TRACT PROCEDURES","code_information":[{"code":"2612","type":"APR-DRG"}],"standard_charges":[{"minimum":48613,"maximum":48613,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48613,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR BILIARY TRACT PROCEDURES","code_information":[{"code":"2613","type":"APR-DRG"}],"standard_charges":[{"minimum":68759,"maximum":68759,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":68759,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR BILIARY TRACT PROCEDURES","code_information":[{"code":"2614","type":"APR-DRG"}],"standard_charges":[{"minimum":130966,"maximum":130966,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":130966,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SCALPEL HARM HAND CNTL CRV","code_information":[{"code":"262005","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":797.16,"maximum":1048.32,"gross_charge":1092,"discounted_cash":633.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1037.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1048.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":797.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":906.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":797.16,"methodology":"fee schedule"}]}]},{"description":"SCALPEL HARM HAND CNTL CRV","code_information":[{"code":"262005","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":349.44,"maximum":1048.32,"gross_charge":1092,"discounted_cash":633.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1037.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1048.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":797.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":906.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":797.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":524.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":378.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":349.44,"methodology":"fee schedule"}]}]},{"description":"CHOLECYSTECTOMY","code_information":[{"code":"2631","type":"APR-DRG"}],"standard_charges":[{"minimum":24551,"maximum":24551,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24551,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHOLECYSTECTOMY","code_information":[{"code":"2632","type":"APR-DRG"}],"standard_charges":[{"minimum":26168,"maximum":26168,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26168,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHOLECYSTECTOMY","code_information":[{"code":"2633","type":"APR-DRG"}],"standard_charges":[{"minimum":32160,"maximum":32160,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32160,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHOLECYSTECTOMY","code_information":[{"code":"2634","type":"APR-DRG"}],"standard_charges":[{"minimum":74827,"maximum":74827,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":74827,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER HEPATOBILIARY PANCREAS AND ABDOMINAL PROCEDURES","code_information":[{"code":"2641","type":"APR-DRG"}],"standard_charges":[{"minimum":30786,"maximum":30786,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30786,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER HEPATOBILIARY PANCREAS AND ABDOMINAL PROCEDURES","code_information":[{"code":"2642","type":"APR-DRG"}],"standard_charges":[{"minimum":36269,"maximum":36269,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36269,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER HEPATOBILIARY PANCREAS AND ABDOMINAL PROCEDURES","code_information":[{"code":"2643","type":"APR-DRG"}],"standard_charges":[{"minimum":45730,"maximum":45730,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45730,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER HEPATOBILIARY PANCREAS AND ABDOMINAL PROCEDURES","code_information":[{"code":"2644","type":"APR-DRG"}],"standard_charges":[{"minimum":120790,"maximum":120790,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":120790,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STAPLER ENDOSCP LIN CUT 45MMX3","code_information":[{"code":"265386","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":521.22,"maximum":685.44,"gross_charge":714,"discounted_cash":414.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":678.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":685.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":521.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":592.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":521.22,"methodology":"fee schedule"}]}]},{"description":"STAPLER ENDOSCP LIN CUT 45MMX3","code_information":[{"code":"265386","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":228.48,"maximum":685.44,"gross_charge":714,"discounted_cash":414.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":678.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":685.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":521.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":592.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":521.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":342.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":247.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":228.48,"methodology":"fee schedule"}]}]},{"description":"DRSNG KT SENSA TRAC GRANU SM","code_information":[{"code":"266947","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":78.11,"maximum":102.72,"gross_charge":107,"discounted_cash":62.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":101.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":102.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":78.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":88.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":78.11,"methodology":"fee schedule"}]}]},{"description":"DRSNG KT SENSA TRAC GRANU SM","code_information":[{"code":"266947","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":34.24,"maximum":102.72,"gross_charge":107,"discounted_cash":62.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":101.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":102.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":78.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":88.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":78.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":37.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":34.24,"methodology":"fee schedule"}]}]},{"description":"TRACH TY CRICOTHROTMY QUIK 4MM","code_information":[{"code":"267576","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":365,"maximum":480,"gross_charge":500,"discounted_cash":290,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":475,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":480,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":365,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":415,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":365,"methodology":"fee schedule"}]}]},{"description":"TRACH TY CRICOTHROTMY QUIK 4MM","code_information":[{"code":"267576","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":160,"maximum":480,"gross_charge":500,"discounted_cash":290,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":475,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":480,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":365,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":415,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":365,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":240,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":173.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":160,"methodology":"fee schedule"}]}]},{"description":"DRSNG KT SENSA TRAC PAD MED","code_information":[{"code":"267928","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":152.57,"maximum":200.64,"gross_charge":209,"discounted_cash":121.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":198.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":200.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":152.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":173.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":152.57,"methodology":"fee schedule"}]}]},{"description":"DRSNG KT SENSA TRAC PAD MED","code_information":[{"code":"267928","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":66.88,"maximum":200.64,"gross_charge":209,"discounted_cash":121.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":198.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":200.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":152.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":173.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":152.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":100.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":72.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":66.88,"methodology":"fee schedule"}]}]},{"description":"CANSTR SENSA W/GEL 500ML","code_information":[{"code":"267930","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":92.71,"maximum":121.92,"gross_charge":127,"discounted_cash":73.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":120.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":121.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":92.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":105.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":92.71,"methodology":"fee schedule"}]}]},{"description":"CANSTR SENSA W/GEL 500ML","code_information":[{"code":"267930","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":40.64,"maximum":121.92,"gross_charge":127,"discounted_cash":73.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":120.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":121.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":92.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":105.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":92.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":60.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":44.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":40.64,"methodology":"fee schedule"}]}]},{"description":"BIT MILL ELEC PEN DRV","code_information":[{"code":"268315","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":865.05,"maximum":1137.6,"gross_charge":1185,"discounted_cash":687.3,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1125.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1137.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":865.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":983.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":865.05,"methodology":"fee schedule"}]}]},{"description":"BIT MILL ELEC PEN DRV","code_information":[{"code":"268315","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":379.2,"maximum":1137.6,"gross_charge":1185,"discounted_cash":687.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1125.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1137.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":865.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":983.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":865.05,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":568.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":410.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":379.2,"methodology":"fee schedule"}]}]},{"description":"BAR TRNVRS USS 6.0X15 TI NS","code_information":[{"code":"269914","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":425.59,"maximum":559.68,"gross_charge":583,"discounted_cash":338.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":553.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":559.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":425.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":483.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":425.59,"methodology":"fee schedule"}]}]},{"description":"BAR TRNVRS USS 6.0X15 TI NS","code_information":[{"code":"269914","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":186.56,"maximum":559.68,"gross_charge":583,"discounted_cash":338.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":553.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":559.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":425.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":483.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":425.59,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":279.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":202.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":186.56,"methodology":"fee schedule"}]}]},{"description":"INJ SI JNT ARTHRO RAD","code_information":[{"code":"27096","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":308.79,"maximum":406.08,"gross_charge":423,"discounted_cash":245.34,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":401.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":308.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":351.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":308.79,"methodology":"fee schedule"}]}]},{"description":"INJ SI JNT ARTHRO RAD","code_information":[{"code":"27096","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":135.36,"maximum":406.08,"gross_charge":423,"discounted_cash":245.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":401.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":308.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":351.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":308.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":203.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":146.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":135.36,"methodology":"fee schedule"}]}]},{"description":"TOTAL HIP ARTHROPLASTY","code_information":[{"code":"27130","type":"CPT"}],"standard_charges":[{"minimum":17555.75,"maximum":17555.75,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17555.75,"methodology":"fee schedule"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_percentage":48,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_percentage":34.68,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_percentage":32,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"TOTAL HIP ARTHROPLASTY","code_information":[{"code":"27132","type":"CPT"}],"standard_charges":[{"minimum":17555.75,"maximum":17555.75,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17555.75,"methodology":"fee schedule"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_percentage":48,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_percentage":34.68,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_percentage":32,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ARTHRODESIS SACROILIAC JOINT","code_information":[{"code":"27279","type":"CPT"}],"standard_charges":[{"minimum":17756.28,"maximum":17756.28,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17756.28,"methodology":"fee schedule"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_percentage":48,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_percentage":34.68,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_percentage":32,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"RECONSTRUCTION KNEE","code_information":[{"code":"27428","type":"CPT"}],"standard_charges":[{"minimum":8253.58,"maximum":8253.58,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":8253.58,"methodology":"fee schedule"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_percentage":48,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_percentage":34.68,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_percentage":32,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"TOTAL KNEE ARTHROPLASTY","code_information":[{"code":"27447","type":"CPT"}],"standard_charges":[{"minimum":17555.75,"maximum":17555.75,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17555.75,"methodology":"fee schedule"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_percentage":48,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_percentage":34.68,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_percentage":32,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"BIT DRL QC 16-STP 2.0X-- NS","code_information":[{"code":"276450","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":453.33,"maximum":596.16,"gross_charge":621,"discounted_cash":360.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":589.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":596.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":453.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":515.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":453.33,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC 16-STP 2.0X-- NS","code_information":[{"code":"276450","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":198.72,"maximum":596.16,"gross_charge":621,"discounted_cash":360.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":589.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":596.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":453.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":515.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":453.33,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":298.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":215.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":198.72,"methodology":"fee schedule"}]}]},{"description":"COLLAR CLMP BDY EXT-FX 6.0MMX1","code_information":[{"code":"278815","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":419.02,"maximum":551.04,"gross_charge":574,"discounted_cash":332.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":545.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":551.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":419.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":476.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":419.02,"methodology":"fee schedule"}]}]},{"description":"COLLAR CLMP BDY EXT-FX 6.0MMX1","code_information":[{"code":"278815","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":183.68,"maximum":551.04,"gross_charge":574,"discounted_cash":332.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":545.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":551.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":419.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":476.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":419.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":275.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":199.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":183.68,"methodology":"fee schedule"}]}]},{"description":"HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS","code_information":[{"code":"2791","type":"APR-DRG"}],"standard_charges":[{"minimum":10433,"maximum":10433,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10433,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS","code_information":[{"code":"2792","type":"APR-DRG"}],"standard_charges":[{"minimum":12805,"maximum":12805,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12805,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS","code_information":[{"code":"2793","type":"APR-DRG"}],"standard_charges":[{"minimum":27727,"maximum":27727,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27727,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS","code_information":[{"code":"2794","type":"APR-DRG"}],"standard_charges":[{"minimum":63724,"maximum":63724,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":63724,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALCOHOLIC LIVER DISEASE","code_information":[{"code":"2801","type":"APR-DRG"}],"standard_charges":[{"minimum":10390,"maximum":10390,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10390,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALCOHOLIC LIVER DISEASE","code_information":[{"code":"2802","type":"APR-DRG"}],"standard_charges":[{"minimum":13405,"maximum":13405,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13405,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALCOHOLIC LIVER DISEASE","code_information":[{"code":"2803","type":"APR-DRG"}],"standard_charges":[{"minimum":26538,"maximum":26538,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26538,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALCOHOLIC LIVER DISEASE","code_information":[{"code":"2804","type":"APR-DRG"}],"standard_charges":[{"minimum":64600,"maximum":64600,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":64600,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CONN TRNS LP USS 38.5-48 TI NS","code_information":[{"code":"280720","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2234.53,"maximum":2938.56,"gross_charge":3061,"discounted_cash":1775.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2907.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2938.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2234.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2540.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2234.53,"methodology":"fee schedule"}]}]},{"description":"CONN TRNS LP USS 38.5-48 TI NS","code_information":[{"code":"280720","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":979.52,"maximum":2938.56,"gross_charge":3061,"discounted_cash":1775.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2907.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2938.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2234.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2540.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2234.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1469.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1061.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":979.52,"methodology":"fee schedule"}]}]},{"description":"MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS","code_information":[{"code":"2811","type":"APR-DRG"}],"standard_charges":[{"minimum":16164,"maximum":16164,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16164,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS","code_information":[{"code":"2812","type":"APR-DRG"}],"standard_charges":[{"minimum":22014,"maximum":22014,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22014,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS","code_information":[{"code":"2813","type":"APR-DRG"}],"standard_charges":[{"minimum":25477,"maximum":25477,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25477,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS","code_information":[{"code":"2814","type":"APR-DRG"}],"standard_charges":[{"minimum":37521,"maximum":37521,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37521,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DISORDERS OF PANCREAS EXCEPT MALIGNANCY","code_information":[{"code":"2821","type":"APR-DRG"}],"standard_charges":[{"minimum":11596,"maximum":11596,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11596,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DISORDERS OF PANCREAS EXCEPT MALIGNANCY","code_information":[{"code":"2822","type":"APR-DRG"}],"standard_charges":[{"minimum":15220,"maximum":15220,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15220,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DISORDERS OF PANCREAS EXCEPT MALIGNANCY","code_information":[{"code":"2823","type":"APR-DRG"}],"standard_charges":[{"minimum":27112,"maximum":27112,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27112,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DISORDERS OF PANCREAS EXCEPT MALIGNANCY","code_information":[{"code":"2824","type":"APR-DRG"}],"standard_charges":[{"minimum":63361,"maximum":63361,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":63361,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DISORDERS OF THE LIVER","code_information":[{"code":"2831","type":"APR-DRG"}],"standard_charges":[{"minimum":7281,"maximum":7281,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":7281,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DISORDERS OF THE LIVER","code_information":[{"code":"2832","type":"APR-DRG"}],"standard_charges":[{"minimum":14192,"maximum":14192,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14192,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DISORDERS OF THE LIVER","code_information":[{"code":"2833","type":"APR-DRG"}],"standard_charges":[{"minimum":15470,"maximum":15470,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15470,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DISORDERS OF THE LIVER","code_information":[{"code":"2834","type":"APR-DRG"}],"standard_charges":[{"minimum":52654,"maximum":52654,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":52654,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"POUCH TAPE 2.25IN FLNG 12IN","code_information":[{"code":"283536","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":4.38,"maximum":5.76,"gross_charge":6,"discounted_cash":3.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4.38,"methodology":"fee schedule"}]}]},{"description":"POUCH TAPE 2.25IN FLNG 12IN","code_information":[{"code":"283536","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":1.92,"maximum":5.76,"gross_charge":6,"discounted_cash":3.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1.92,"methodology":"fee schedule"}]}]},{"description":"DISORDERS OF GALLBLADDER AND BILIARY TRACT","code_information":[{"code":"2841","type":"APR-DRG"}],"standard_charges":[{"minimum":15088,"maximum":15088,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15088,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DISORDERS OF GALLBLADDER AND BILIARY TRACT","code_information":[{"code":"2842","type":"APR-DRG"}],"standard_charges":[{"minimum":22340,"maximum":22340,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22340,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DISORDERS OF GALLBLADDER AND BILIARY TRACT","code_information":[{"code":"2843","type":"APR-DRG"}],"standard_charges":[{"minimum":32456,"maximum":32456,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32456,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DISORDERS OF GALLBLADDER AND BILIARY TRACT","code_information":[{"code":"2844","type":"APR-DRG"}],"standard_charges":[{"minimum":52472,"maximum":52472,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":52472,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SUT VICRYL PLUS 0 27IN UR5","code_information":[{"code":"287662","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":7.93,"maximum":10.42,"gross_charge":10.85,"discounted_cash":6.3,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":10.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":10.42,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7.93,"methodology":"fee schedule"}]}]},{"description":"SUT VICRYL PLUS 0 27IN UR5","code_information":[{"code":"287662","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":3.48,"maximum":10.42,"gross_charge":10.85,"discounted_cash":6.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":10.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":10.42,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3.48,"methodology":"fee schedule"}]}]},{"description":"TB GASTSTMY MIC 16FR","code_information":[{"code":"289970","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":176.66,"maximum":232.32,"gross_charge":242,"discounted_cash":140.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":229.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":232.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":176.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":200.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":176.66,"methodology":"fee schedule"}]}]},{"description":"TB GASTSTMY MIC 16FR","code_information":[{"code":"289970","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":77.44,"maximum":232.32,"gross_charge":242,"discounted_cash":140.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":229.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":232.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":176.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":200.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":176.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":116.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":83.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":77.44,"methodology":"fee schedule"}]}]},{"description":"RING SYS MALYUGIN 6.25MM","code_information":[{"code":"298169","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":339.45,"maximum":446.4,"gross_charge":465,"discounted_cash":269.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":441.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":446.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":339.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":385.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":339.45,"methodology":"fee schedule"}]}]},{"description":"RING SYS MALYUGIN 6.25MM","code_information":[{"code":"298169","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":148.8,"maximum":446.4,"gross_charge":465,"discounted_cash":269.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":441.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":446.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":339.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":385.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":339.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":223.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":161.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":148.8,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL 3-0 36IN + ANTIB CT","code_information":[{"code":"298194","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":20.34,"maximum":26.75,"gross_charge":27.86,"discounted_cash":16.16,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":26.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":26.75,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":20.34,"methodology":"fee schedule"}]}]},{"description":"SUT VCRL 3-0 36IN + ANTIB CT","code_information":[{"code":"298194","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":8.92,"maximum":26.75,"gross_charge":27.86,"discounted_cash":16.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":26.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":26.75,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":20.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":13.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.92,"methodology":"fee schedule"}]}]},{"description":"CATH CLOSURE FAST 7FR 100CM","code_information":[{"code":"298960","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2062.25,"maximum":2712,"gross_charge":2825,"discounted_cash":1638.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2683.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2712,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2062.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2344.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2062.25,"methodology":"fee schedule"}]}]},{"description":"CATH CLOSURE FAST 7FR 100CM","code_information":[{"code":"298960","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":904,"maximum":2712,"gross_charge":2825,"discounted_cash":1638.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2683.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2712,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2062.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2344.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2062.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1356,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":979.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":904,"methodology":"fee schedule"}]}]},{"description":"FLOW LAMINAR PHACO TIP 30D 30G","code_information":[{"code":"301669","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1394.3,"maximum":1833.6,"gross_charge":1910,"discounted_cash":1107.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1814.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1833.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1394.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1585.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1394.3,"methodology":"fee schedule"}]}]},{"description":"FLOW LAMINAR PHACO TIP 30D 30G","code_information":[{"code":"301669","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":611.2,"maximum":1833.6,"gross_charge":1910,"discounted_cash":1107.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1814.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1833.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1394.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1585.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1394.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":916.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":662.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":611.2,"methodology":"fee schedule"}]}]},{"description":"ELECTRD DEFIB PED GRDNT EDGE","code_information":[{"code":"302682","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":50.02,"maximum":65.77,"gross_charge":68.51,"discounted_cash":39.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":65.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":65.77,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":50.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":56.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":50.02,"methodology":"fee schedule"}]}]},{"description":"ELECTRD DEFIB PED GRDNT EDGE","code_information":[{"code":"302682","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":21.93,"maximum":65.77,"gross_charge":68.51,"discounted_cash":39.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":65.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":65.77,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":50.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":56.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":50.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":32.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":23.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":21.93,"methodology":"fee schedule"}]}]},{"description":"SOL IRR BSS UD 15ML STRL","code_information":[{"code":"302876","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":17.73,"maximum":23.31,"gross_charge":24.28,"discounted_cash":14.09,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":23.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":23.31,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":17.73,"methodology":"fee schedule"}]}]},{"description":"SOL IRR BSS UD 15ML STRL","code_information":[{"code":"302876","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":7.77,"maximum":23.31,"gross_charge":24.28,"discounted_cash":14.09,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":23.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":23.31,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":17.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":20.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":17.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":11.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":8.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.77,"methodology":"fee schedule"}]}]},{"description":"DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK","code_information":[{"code":"3031","type":"APR-DRG"}],"standard_charges":[{"minimum":96513,"maximum":96513,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":96513,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK","code_information":[{"code":"3032","type":"APR-DRG"}],"standard_charges":[{"minimum":127529,"maximum":127529,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":127529,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK","code_information":[{"code":"3033","type":"APR-DRG"}],"standard_charges":[{"minimum":179644,"maximum":179644,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":179644,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEVICE HEMSTAT CLIP 235CM EAX1","code_information":[{"code":"303305","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":372.3,"maximum":489.6,"gross_charge":510,"discounted_cash":295.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":484.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":489.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":372.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":423.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":372.3,"methodology":"fee schedule"}]}]},{"description":"DEVICE HEMSTAT CLIP 235CM EAX1","code_information":[{"code":"303305","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":163.2,"maximum":489.6,"gross_charge":510,"discounted_cash":295.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":484.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":489.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":372.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":423.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":372.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":244.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":176.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":163.2,"methodology":"fee schedule"}]}]},{"description":"DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK","code_information":[{"code":"3034","type":"APR-DRG"}],"standard_charges":[{"minimum":235503,"maximum":235503,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":235503,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NDL INJ THERAPY 23G","code_information":[{"code":"304064","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":85.99,"maximum":113.08,"gross_charge":117.79,"discounted_cash":68.32,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":111.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":113.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":85.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":85.99,"methodology":"fee schedule"}]}]},{"description":"NDL INJ THERAPY 23G","code_information":[{"code":"304064","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":37.7,"maximum":113.08,"gross_charge":117.79,"discounted_cash":68.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":111.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":113.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":85.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":85.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":40.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":37.7,"methodology":"fee schedule"}]}]},{"description":"DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK","code_information":[{"code":"3041","type":"APR-DRG"}],"standard_charges":[{"minimum":58652,"maximum":58652,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":58652,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK","code_information":[{"code":"3042","type":"APR-DRG"}],"standard_charges":[{"minimum":76775,"maximum":76775,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":76775,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK","code_information":[{"code":"3043","type":"APR-DRG"}],"standard_charges":[{"minimum":94560,"maximum":94560,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":94560,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK","code_information":[{"code":"3044","type":"APR-DRG"}],"standard_charges":[{"minimum":183890,"maximum":183890,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":183890,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"AMPUTATION OF LOWER LIMB EXCEPT TOES","code_information":[{"code":"3051","type":"APR-DRG"}],"standard_charges":[{"minimum":27829,"maximum":27829,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27829,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"AMPUTATION OF LOWER LIMB EXCEPT TOES","code_information":[{"code":"3052","type":"APR-DRG"}],"standard_charges":[{"minimum":28192,"maximum":28192,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28192,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"AMPUTATION OF LOWER LIMB EXCEPT TOES","code_information":[{"code":"3053","type":"APR-DRG"}],"standard_charges":[{"minimum":48404,"maximum":48404,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48404,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"AMPUTATION OF LOWER LIMB EXCEPT TOES","code_information":[{"code":"3054","type":"APR-DRG"}],"standard_charges":[{"minimum":93534,"maximum":93534,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":93534,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DRL BIT 1.5X12MM","code_information":[{"code":"307814","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":224.84,"maximum":295.68,"gross_charge":308,"discounted_cash":178.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":295.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":224.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":255.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":224.84,"methodology":"fee schedule"}]}]},{"description":"DRL BIT 1.5X12MM","code_information":[{"code":"307814","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":98.56,"maximum":295.68,"gross_charge":308,"discounted_cash":178.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":295.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":224.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":255.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":224.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":147.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":106.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":98.56,"methodology":"fee schedule"}]}]},{"description":"HIP AND FEMUR FRACTURE REPAIR","code_information":[{"code":"3081","type":"APR-DRG"}],"standard_charges":[{"minimum":24031,"maximum":24031,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24031,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HIP AND FEMUR FRACTURE REPAIR","code_information":[{"code":"3082","type":"APR-DRG"}],"standard_charges":[{"minimum":33895,"maximum":33895,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33895,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HIP AND FEMUR FRACTURE REPAIR","code_information":[{"code":"3083","type":"APR-DRG"}],"standard_charges":[{"minimum":47645,"maximum":47645,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":47645,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTRD CADENCE PRECONNECT","code_information":[{"code":"308379","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":48.32,"maximum":63.55,"gross_charge":66.19,"discounted_cash":38.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":62.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":63.55,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":48.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":54.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":48.32,"methodology":"fee schedule"}]}]},{"description":"ELECTRD CADENCE PRECONNECT","code_information":[{"code":"308379","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":21.19,"maximum":63.55,"gross_charge":66.19,"discounted_cash":38.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":62.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":63.55,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":48.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":54.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":48.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":31.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":22.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":21.19,"methodology":"fee schedule"}]}]},{"description":"HIP AND FEMUR FRACTURE REPAIR","code_information":[{"code":"3084","type":"APR-DRG"}],"standard_charges":[{"minimum":78921,"maximum":78921,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":78921,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DRL TAP 6.0MM","code_information":[{"code":"308447","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":667.22,"maximum":877.44,"gross_charge":914,"discounted_cash":530.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":868.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":877.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":667.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":758.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":667.22,"methodology":"fee schedule"}]}]},{"description":"DRL TAP 6.0MM","code_information":[{"code":"308447","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":292.48,"maximum":877.44,"gross_charge":914,"discounted_cash":530.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":868.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":877.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":667.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":758.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":667.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":438.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":316.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":292.48,"methodology":"fee schedule"}]}]},{"description":"OTHER SIGNIFICANT HIP AND FEMUR SURGERY","code_information":[{"code":"3091","type":"APR-DRG"}],"standard_charges":[{"minimum":30853,"maximum":30853,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30853,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER SIGNIFICANT HIP AND FEMUR SURGERY","code_information":[{"code":"3092","type":"APR-DRG"}],"standard_charges":[{"minimum":34025,"maximum":34025,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34025,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER SIGNIFICANT HIP AND FEMUR SURGERY","code_information":[{"code":"3093","type":"APR-DRG"}],"standard_charges":[{"minimum":69709,"maximum":69709,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":69709,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER SIGNIFICANT HIP AND FEMUR SURGERY","code_information":[{"code":"3094","type":"APR-DRG"}],"standard_charges":[{"minimum":106996,"maximum":106996,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":106996,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTERVERTEBRAL DISC EXCISION AND DECOMPRESSION","code_information":[{"code":"3101","type":"APR-DRG"}],"standard_charges":[{"minimum":17620,"maximum":17620,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17620,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTERVERTEBRAL DISC EXCISION AND DECOMPRESSION","code_information":[{"code":"3102","type":"APR-DRG"}],"standard_charges":[{"minimum":34695,"maximum":34695,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34695,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTERVERTEBRAL DISC EXCISION AND DECOMPRESSION","code_information":[{"code":"3103","type":"APR-DRG"}],"standard_charges":[{"minimum":50448,"maximum":50448,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50448,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTERVERTEBRAL DISC EXCISION AND DECOMPRESSION","code_information":[{"code":"3104","type":"APR-DRG"}],"standard_charges":[{"minimum":93421,"maximum":93421,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":93421,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HEALON 0.85","code_information":[{"code":"311741","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":124.1,"maximum":163.2,"gross_charge":170,"discounted_cash":98.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":161.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":163.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":124.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":141.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":124.1,"methodology":"fee schedule"}]}]},{"description":"HEALON 0.85","code_information":[{"code":"311741","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":54.4,"maximum":163.2,"gross_charge":170,"discounted_cash":98.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":161.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":163.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":124.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":141.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":124.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":81.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":58.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":54.4,"methodology":"fee schedule"}]}]},{"description":"SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES","code_information":[{"code":"3121","type":"APR-DRG"}],"standard_charges":[{"minimum":31695,"maximum":31695,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31695,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES","code_information":[{"code":"3122","type":"APR-DRG"}],"standard_charges":[{"minimum":53622,"maximum":53622,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":53622,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES","code_information":[{"code":"3123","type":"APR-DRG"}],"standard_charges":[{"minimum":79173,"maximum":79173,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":79173,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES","code_information":[{"code":"3124","type":"APR-DRG"}],"standard_charges":[{"minimum":160563,"maximum":160563,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":160563,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT","code_information":[{"code":"3131","type":"APR-DRG"}],"standard_charges":[{"minimum":26625,"maximum":26625,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26625,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT","code_information":[{"code":"3132","type":"APR-DRG"}],"standard_charges":[{"minimum":35564,"maximum":35564,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":35564,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT","code_information":[{"code":"3133","type":"APR-DRG"}],"standard_charges":[{"minimum":62429,"maximum":62429,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":62429,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT","code_information":[{"code":"3134","type":"APR-DRG"}],"standard_charges":[{"minimum":106306,"maximum":106306,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":106306,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FOOT AND TOE PROCEDURES","code_information":[{"code":"3141","type":"APR-DRG"}],"standard_charges":[{"minimum":18970,"maximum":18970,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18970,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FOOT AND TOE PROCEDURES","code_information":[{"code":"3142","type":"APR-DRG"}],"standard_charges":[{"minimum":20194,"maximum":20194,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20194,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FOOT AND TOE PROCEDURES","code_information":[{"code":"3143","type":"APR-DRG"}],"standard_charges":[{"minimum":29632,"maximum":29632,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29632,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HOOK LAM 2 OPN SID MED TI","code_information":[{"code":"314370","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1662.21,"maximum":2185.92,"gross_charge":2277,"discounted_cash":1320.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2163.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2185.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1662.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1889.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1662.21,"methodology":"fee schedule"}]}]},{"description":"HOOK LAM 2 OPN SID MED TI","code_information":[{"code":"314370","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":728.64,"maximum":2185.92,"gross_charge":2277,"discounted_cash":1320.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2163.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2185.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1662.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1889.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1662.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1092.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":789.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":728.64,"methodology":"fee schedule"}]}]},{"description":"FOOT AND TOE PROCEDURES","code_information":[{"code":"3144","type":"APR-DRG"}],"standard_charges":[{"minimum":53546,"maximum":53546,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":53546,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SHOULDER UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT","code_information":[{"code":"3151","type":"APR-DRG"}],"standard_charges":[{"minimum":19327,"maximum":19327,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19327,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SHOULDER UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT","code_information":[{"code":"3152","type":"APR-DRG"}],"standard_charges":[{"minimum":36134,"maximum":36134,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36134,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SHOULDER UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT","code_information":[{"code":"3153","type":"APR-DRG"}],"standard_charges":[{"minimum":52150,"maximum":52150,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":52150,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SHOULDER UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT","code_information":[{"code":"3154","type":"APR-DRG"}],"standard_charges":[{"minimum":99628,"maximum":99628,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":99628,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH FOL COUDE SIL 16X5 LF","code_information":[{"code":"315474","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":57.67,"maximum":75.84,"gross_charge":79,"discounted_cash":45.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":75.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":57.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":65.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":57.67,"methodology":"fee schedule"}]}]},{"description":"CATH FOL COUDE SIL 16X5 LF","code_information":[{"code":"315474","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":25.28,"maximum":75.84,"gross_charge":79,"discounted_cash":45.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":75.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":57.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":65.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":57.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":37.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":27.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":25.28,"methodology":"fee schedule"}]}]},{"description":"PACK FAST CLOSURE","code_information":[{"code":"315562","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":277.4,"maximum":364.8,"gross_charge":380,"discounted_cash":220.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":361,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":364.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":277.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":315.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":277.4,"methodology":"fee schedule"}]}]},{"description":"PACK FAST CLOSURE","code_information":[{"code":"315562","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":121.6,"maximum":364.8,"gross_charge":380,"discounted_cash":220.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":361,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":364.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":277.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":315.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":277.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":182.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":131.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":121.6,"methodology":"fee schedule"}]}]},{"description":"HAND AND WRIST PROCEDURES","code_information":[{"code":"3161","type":"APR-DRG"}],"standard_charges":[{"minimum":16335,"maximum":16335,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16335,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HAND AND WRIST PROCEDURES","code_information":[{"code":"3162","type":"APR-DRG"}],"standard_charges":[{"minimum":24281,"maximum":24281,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24281,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HAND AND WRIST PROCEDURES","code_information":[{"code":"3163","type":"APR-DRG"}],"standard_charges":[{"minimum":43347,"maximum":43347,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43347,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HAND AND WRIST PROCEDURES","code_information":[{"code":"3164","type":"APR-DRG"}],"standard_charges":[{"minimum":79916,"maximum":79916,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":79916,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TENDON MUSCLE AND OTHER SOFT TISSUE PROCEDURES","code_information":[{"code":"3171","type":"APR-DRG"}],"standard_charges":[{"minimum":21425,"maximum":21425,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21425,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TENDON MUSCLE AND OTHER SOFT TISSUE PROCEDURES","code_information":[{"code":"3172","type":"APR-DRG"}],"standard_charges":[{"minimum":29892,"maximum":29892,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29892,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TENDON MUSCLE AND OTHER SOFT TISSUE PROCEDURES","code_information":[{"code":"3173","type":"APR-DRG"}],"standard_charges":[{"minimum":50363,"maximum":50363,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50363,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TENDON MUSCLE AND OTHER SOFT TISSUE PROCEDURES","code_information":[{"code":"3174","type":"APR-DRG"}],"standard_charges":[{"minimum":81538,"maximum":81538,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":81538,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"POWDER EZ HD 12OZ","code_information":[{"code":"319041","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":6.57,"maximum":8.64,"gross_charge":9,"discounted_cash":5.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6.57,"methodology":"fee schedule"}]}]},{"description":"POWDER EZ HD 12OZ","code_information":[{"code":"319041","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":2.88,"maximum":8.64,"gross_charge":9,"discounted_cash":5.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.88,"methodology":"fee schedule"}]}]},{"description":"SYS BMA 15CM W/O SIDE HOLES","code_information":[{"code":"319417","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":255.5,"maximum":336,"gross_charge":350,"discounted_cash":203,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":336,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":255.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":290.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":255.5,"methodology":"fee schedule"}]}]},{"description":"SYS BMA 15CM W/O SIDE HOLES","code_information":[{"code":"319417","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":112,"maximum":336,"gross_charge":350,"discounted_cash":203,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":336,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":255.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":290.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":255.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":168,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":121.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":112,"methodology":"fee schedule"}]}]},{"description":"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES","code_information":[{"code":"3201","type":"APR-DRG"}],"standard_charges":[{"minimum":21190,"maximum":21190,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21190,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES","code_information":[{"code":"3202","type":"APR-DRG"}],"standard_charges":[{"minimum":28636,"maximum":28636,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28636,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES","code_information":[{"code":"3203","type":"APR-DRG"}],"standard_charges":[{"minimum":43271,"maximum":43271,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43271,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES","code_information":[{"code":"3204","type":"APR-DRG"}],"standard_charges":[{"minimum":85819,"maximum":85819,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":85819,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DRSNG AQUACEL AG HYDROFIBER ST","code_information":[{"code":"320666","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":35.04,"maximum":46.08,"gross_charge":48,"discounted_cash":27.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":45.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":46.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.04,"methodology":"fee schedule"}]}]},{"description":"DRSNG AQUACEL AG HYDROFIBER ST","code_information":[{"code":"320666","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":15.36,"maximum":46.08,"gross_charge":48,"discounted_cash":27.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":45.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":46.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":15.36,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINAL FUSION AND OTHER BACK OR NECK PROCEDURES EXCEPT DISC EXCISION OR DECOMPRESSION","code_information":[{"code":"3211","type":"APR-DRG"}],"standard_charges":[{"minimum":35106,"maximum":35106,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":35106,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CERVICAL SPINAL FUSION AND OTHER BACK OR NECK PROCEDURES EXCEPT DISC EXCISION OR DECOMPRESSION","code_information":[{"code":"3212","type":"APR-DRG"}],"standard_charges":[{"minimum":45211,"maximum":45211,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45211,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CERVICAL SPINAL FUSION AND OTHER BACK OR NECK PROCEDURES EXCEPT DISC EXCISION OR DECOMPRESSION","code_information":[{"code":"3213","type":"APR-DRG"}],"standard_charges":[{"minimum":72131,"maximum":72131,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":72131,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CERVICAL SPINAL FUSION AND OTHER BACK OR NECK PROCEDURES EXCEPT DISC EXCISION OR DECOMPRESSION","code_information":[{"code":"3214","type":"APR-DRG"}],"standard_charges":[{"minimum":128203,"maximum":128203,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":128203,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SHOULDER AND ELBOW JOINT REPLACEMENT","code_information":[{"code":"3221","type":"APR-DRG"}],"standard_charges":[{"minimum":23834,"maximum":23834,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23834,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SHOULDER AND ELBOW JOINT REPLACEMENT","code_information":[{"code":"3222","type":"APR-DRG"}],"standard_charges":[{"minimum":25677,"maximum":25677,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25677,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SHOULDER AND ELBOW JOINT REPLACEMENT","code_information":[{"code":"3223","type":"APR-DRG"}],"standard_charges":[{"minimum":67146,"maximum":67146,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":67146,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SHOULDER AND ELBOW JOINT REPLACEMENT","code_information":[{"code":"3224","type":"APR-DRG"}],"standard_charges":[{"minimum":89906,"maximum":89906,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":89906,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT","code_information":[{"code":"3231","type":"APR-DRG"}],"standard_charges":[{"minimum":31377,"maximum":31377,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31377,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT","code_information":[{"code":"3232","type":"APR-DRG"}],"standard_charges":[{"minimum":41917,"maximum":41917,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41917,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT","code_information":[{"code":"3233","type":"APR-DRG"}],"standard_charges":[{"minimum":51963,"maximum":51963,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":51963,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT","code_information":[{"code":"3234","type":"APR-DRG"}],"standard_charges":[{"minimum":104030,"maximum":104030,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":104030,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTIVE HIP JOINT REPLACEMENT","code_information":[{"code":"3241","type":"APR-DRG"}],"standard_charges":[{"minimum":22016,"maximum":22016,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22016,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTIVE HIP JOINT REPLACEMENT","code_information":[{"code":"3242","type":"APR-DRG"}],"standard_charges":[{"minimum":22579,"maximum":22579,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22579,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BAR TRNVRS 3.5MM TI","code_information":[{"code":"324264","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":590.57,"maximum":776.64,"gross_charge":809,"discounted_cash":469.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":768.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":776.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":590.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":671.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":590.57,"methodology":"fee schedule"}]}]},{"description":"BAR TRNVRS 3.5MM TI","code_information":[{"code":"324264","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":258.88,"maximum":776.64,"gross_charge":809,"discounted_cash":469.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":768.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":776.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":590.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":671.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":590.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":388.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":280.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":258.88,"methodology":"fee schedule"}]}]},{"description":"ELECTIVE HIP JOINT REPLACEMENT","code_information":[{"code":"3243","type":"APR-DRG"}],"standard_charges":[{"minimum":56120,"maximum":56120,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":56120,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTIVE HIP JOINT REPLACEMENT","code_information":[{"code":"3244","type":"APR-DRG"}],"standard_charges":[{"minimum":90195,"maximum":90195,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":90195,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT","code_information":[{"code":"3251","type":"APR-DRG"}],"standard_charges":[{"minimum":48304,"maximum":48304,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48304,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT","code_information":[{"code":"3252","type":"APR-DRG"}],"standard_charges":[{"minimum":54672,"maximum":54672,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":54672,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT","code_information":[{"code":"3253","type":"APR-DRG"}],"standard_charges":[{"minimum":80064,"maximum":80064,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":80064,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT","code_information":[{"code":"3254","type":"APR-DRG"}],"standard_charges":[{"minimum":131592,"maximum":131592,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":131592,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTIVE KNEE JOINT REPLACEMENT","code_information":[{"code":"3261","type":"APR-DRG"}],"standard_charges":[{"minimum":21464,"maximum":21464,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21464,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTIVE KNEE JOINT REPLACEMENT","code_information":[{"code":"3262","type":"APR-DRG"}],"standard_charges":[{"minimum":32290,"maximum":32290,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32290,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTIVE KNEE JOINT REPLACEMENT","code_information":[{"code":"3263","type":"APR-DRG"}],"standard_charges":[{"minimum":42804,"maximum":42804,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":42804,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ELECTIVE KNEE JOINT REPLACEMENT","code_information":[{"code":"3264","type":"APR-DRG"}],"standard_charges":[{"minimum":76475,"maximum":76475,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":76475,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TY AMNIO SAFET PL 20GX3.5IN","code_information":[{"code":"329713","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":47.45,"maximum":62.4,"gross_charge":65,"discounted_cash":37.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":61.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":62.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":47.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":53.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":47.45,"methodology":"fee schedule"}]}]},{"description":"TY AMNIO SAFET PL 20GX3.5IN","code_information":[{"code":"329713","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":20.8,"maximum":62.4,"gross_charge":65,"discounted_cash":37.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":61.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":62.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":47.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":53.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":47.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":31.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":22.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":20.8,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC W/STOP 3.2X65MM","code_information":[{"code":"331943","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":313.17,"maximum":411.84,"gross_charge":429,"discounted_cash":248.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":407.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":411.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":313.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":356.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":313.17,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC W/STOP 3.2X65MM","code_information":[{"code":"331943","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":137.28,"maximum":411.84,"gross_charge":429,"discounted_cash":248.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":407.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":411.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":313.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":356.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":313.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":205.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":148.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":137.28,"methodology":"fee schedule"}]}]},{"description":"CLAMP TRANS CONN","code_information":[{"code":"332472","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":873.08,"maximum":1148.16,"gross_charge":1196,"discounted_cash":693.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1136.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1148.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":873.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":992.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":873.08,"methodology":"fee schedule"}]}]},{"description":"CLAMP TRANS CONN","code_information":[{"code":"332472","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":382.72,"maximum":1148.16,"gross_charge":1196,"discounted_cash":693.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1136.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1148.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":873.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":992.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":873.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":574.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":414.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":382.72,"methodology":"fee schedule"}]}]},{"description":"DRSNG ACTICOAT FLEX 7 4X5","code_information":[{"code":"334198","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":37.23,"maximum":48.96,"gross_charge":51,"discounted_cash":29.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":48.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":48.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":37.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":42.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":37.23,"methodology":"fee schedule"}]}]},{"description":"DRSNG ACTICOAT FLEX 7 4X5","code_information":[{"code":"334198","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":16.32,"maximum":48.96,"gross_charge":51,"discounted_cash":29.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":48.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":48.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":37.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":42.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":37.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":24.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":17.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.32,"methodology":"fee schedule"}]}]},{"description":"CABLE SPNE DBL-LD CRMP 1.0X470","code_information":[{"code":"334982","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":707.37,"maximum":930.24,"gross_charge":969,"discounted_cash":562.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":920.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":930.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":707.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":804.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":707.37,"methodology":"fee schedule"}]}]},{"description":"CABLE SPNE DBL-LD CRMP 1.0X470","code_information":[{"code":"334982","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":310.08,"maximum":930.24,"gross_charge":969,"discounted_cash":562.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":920.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":930.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":707.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":804.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":707.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":465.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":336.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":310.08,"methodology":"fee schedule"}]}]},{"description":"COLLET TI","code_information":[{"code":"336266","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":845.34,"maximum":1111.68,"gross_charge":1158,"discounted_cash":671.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1100.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1111.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":845.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":961.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":845.34,"methodology":"fee schedule"}]}]},{"description":"COLLET TI","code_information":[{"code":"336266","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":370.56,"maximum":1111.68,"gross_charge":1158,"discounted_cash":671.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1100.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1111.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":845.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":961.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":845.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":555.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":401.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":370.56,"methodology":"fee schedule"}]}]},{"description":"CLAMP ILIAC CONN FIXED LN","code_information":[{"code":"336269","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1975.38,"maximum":2597.76,"gross_charge":2706,"discounted_cash":1569.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2570.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2597.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1975.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2245.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1975.38,"methodology":"fee schedule"}]}]},{"description":"CLAMP ILIAC CONN FIXED LN","code_information":[{"code":"336269","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":865.92,"maximum":2597.76,"gross_charge":2706,"discounted_cash":1569.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2570.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2597.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1975.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2245.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1975.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1298.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":938.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":865.92,"methodology":"fee schedule"}]}]},{"description":"FRACTURE OF FEMUR","code_information":[{"code":"3401","type":"APR-DRG"}],"standard_charges":[{"minimum":9524,"maximum":9524,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9524,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRACTURE OF FEMUR","code_information":[{"code":"3402","type":"APR-DRG"}],"standard_charges":[{"minimum":11840,"maximum":11840,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11840,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRACTURE OF FEMUR","code_information":[{"code":"3403","type":"APR-DRG"}],"standard_charges":[{"minimum":24112,"maximum":24112,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24112,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRACTURE OF FEMUR","code_information":[{"code":"3404","type":"APR-DRG"}],"standard_charges":[{"minimum":31595,"maximum":31595,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31595,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BIT DRL 20MM BIOCORT SCRS","code_information":[{"code":"340425","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":478.88,"maximum":629.76,"gross_charge":656,"discounted_cash":380.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":623.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":629.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":478.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":544.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":478.88,"methodology":"fee schedule"}]}]},{"description":"BIT DRL 20MM BIOCORT SCRS","code_information":[{"code":"340425","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":209.92,"maximum":629.76,"gross_charge":656,"discounted_cash":380.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":623.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":629.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":478.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":544.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":478.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":314.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":227.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":209.92,"methodology":"fee schedule"}]}]},{"description":"FRACTURE OF PELVIS OR DISLOCATION OF HIP","code_information":[{"code":"3411","type":"APR-DRG"}],"standard_charges":[{"minimum":12759,"maximum":12759,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12759,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPECIAL CARE","code_information":[{"code":"3411100001","type":"CDM"},{"code":"0119","type":"RC"}],"standard_charges":[{"minimum":1844.71,"maximum":2425.92,"gross_charge":2527,"discounted_cash":1465.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2400.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2425.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1844.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2097.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1844.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ISOLATION ROOM","code_information":[{"code":"3411100002","type":"CDM"},{"code":"0111","type":"RC"}],"standard_charges":[{"minimum":1108.87,"maximum":1458.24,"gross_charge":1519,"discounted_cash":881.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1458.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1108.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1260.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1108.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ROUTINE ROOM","code_information":[{"code":"3411100004","type":"CDM"},{"code":"0111","type":"RC"}],"standard_charges":[{"minimum":1044.63,"maximum":1373.76,"gross_charge":1431,"discounted_cash":829.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1359.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1373.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1044.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1187.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1044.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRACTURE OF PELVIS OR DISLOCATION OF HIP","code_information":[{"code":"3412","type":"APR-DRG"}],"standard_charges":[{"minimum":15498,"maximum":15498,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15498,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RESPITE CARE","code_information":[{"code":"3412000002","type":"CDM"},{"code":"0111","type":"RC"}],"standard_charges":[{"minimum":280.32,"maximum":368.64,"gross_charge":384,"discounted_cash":222.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":364.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":368.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":280.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":318.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":280.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SWG BED W/SKIN INTEGRITY","code_information":[{"code":"3412000003","type":"CDM"},{"code":"0111","type":"RC"}],"standard_charges":[{"minimum":586.19,"maximum":770.88,"gross_charge":803,"discounted_cash":465.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":762.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":770.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":586.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":666.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":586.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SWING BED","code_information":[{"code":"3412000004","type":"CDM"},{"code":"0111","type":"RC"}],"standard_charges":[{"minimum":521.95,"maximum":686.4,"gross_charge":715,"discounted_cash":414.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":679.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":686.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":521.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":593.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":521.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RESPITE CARE/ACCUCAIR","code_information":[{"code":"3412000006","type":"CDM"},{"code":"0120","type":"RC"}],"standard_charges":[{"minimum":331.42,"maximum":435.84,"gross_charge":454,"discounted_cash":263.32,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":431.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":435.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":331.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":376.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":331.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRACTURE OF PELVIS OR DISLOCATION OF HIP","code_information":[{"code":"3413","type":"APR-DRG"}],"standard_charges":[{"minimum":21349,"maximum":21349,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21349,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRACTURE OF PELVIS OR DISLOCATION OF HIP","code_information":[{"code":"3414","type":"APR-DRG"}],"standard_charges":[{"minimum":40726,"maximum":40726,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":40726,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRACTURES AND DISLOCATIONS EXCEPT FEMUR PELVIS AND BACK","code_information":[{"code":"3421","type":"APR-DRG"}],"standard_charges":[{"minimum":14503,"maximum":14503,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14503,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRACTURES AND DISLOCATIONS EXCEPT FEMUR PELVIS AND BACK","code_information":[{"code":"3422","type":"APR-DRG"}],"standard_charges":[{"minimum":15868,"maximum":15868,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15868,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRACTURES AND DISLOCATIONS EXCEPT FEMUR PELVIS AND BACK","code_information":[{"code":"3423","type":"APR-DRG"}],"standard_charges":[{"minimum":19583,"maximum":19583,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19583,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FRACTURES AND DISLOCATIONS EXCEPT FEMUR PELVIS AND BACK","code_information":[{"code":"3424","type":"APR-DRG"}],"standard_charges":[{"minimum":38652,"maximum":38652,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38652,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"IV HYD 1ST HR (31-90M) ACU","code_information":[{"code":"3426000001","type":"CDM"},{"code":"0260","type":"RC"}],"standard_charges":[{"minimum":240.96,"maximum":722.88,"gross_charge":753,"discounted_cash":436.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":715.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":722.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":549.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":624.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":549.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":361.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":261.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":240.96,"methodology":"fee schedule"}]}]},{"description":"IV HYD EA ADD HR (91M+) ACU","code_information":[{"code":"3426000002","type":"CDM"},{"code":"0260","type":"RC"}],"standard_charges":[{"minimum":45.12,"maximum":135.36,"gross_charge":141,"discounted_cash":81.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":133.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":135.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":102.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":117.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":102.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":48.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":45.12,"methodology":"fee schedule"}]}]},{"description":"INJ SUBQ/IM ACU","code_information":[{"code":"3426000005","type":"CDM"},{"code":"0260","type":"RC"}],"standard_charges":[{"minimum":68.8,"maximum":206.4,"gross_charge":215,"discounted_cash":124.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":204.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":206.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":156.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":178.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":156.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":74.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":68.8,"methodology":"fee schedule"}]}]},{"description":"IV PUSH INITIAL/SINGLE ACU","code_information":[{"code":"3426000006","type":"CDM"},{"code":"0260","type":"RC"}],"standard_charges":[{"minimum":241.6,"maximum":724.8,"gross_charge":755,"discounted_cash":437.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":717.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":724.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":551.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":626.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":551.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":362.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":261.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":241.6,"methodology":"fee schedule"}]}]},{"description":"IV PUSH EA ADD DIFF RX ACU","code_information":[{"code":"3426000008","type":"CDM"},{"code":"0260","type":"RC"}],"standard_charges":[{"minimum":73.28,"maximum":219.84,"gross_charge":229,"discounted_cash":132.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":217.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":219.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":167.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":190.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":167.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":79.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":73.28,"methodology":"fee schedule"}]}]},{"description":"IV INF CONCURR PER DAY ACU","code_information":[{"code":"3426000009","type":"CDM"},{"code":"0260","type":"RC"}],"standard_charges":[{"minimum":128.96,"maximum":386.88,"gross_charge":403,"discounted_cash":233.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":382.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":386.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":294.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":334.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":294.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":193.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":139.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":128.96,"methodology":"fee schedule"}]}]},{"description":"IV INF SEQ EA ADDL HR ACU","code_information":[{"code":"3426000010","type":"CDM"},{"code":"0260","type":"RC"}],"standard_charges":[{"minimum":72.64,"maximum":217.92,"gross_charge":227,"discounted_cash":131.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":215.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":188.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.64,"methodology":"fee schedule"}]}]},{"description":"IV PUSH EA ADD SAME RX ACU","code_information":[{"code":"3426000027","type":"CDM"},{"code":"0260","type":"RC"}],"standard_charges":[{"minimum":78.08,"maximum":234.24,"gross_charge":244,"discounted_cash":141.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":231.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":234.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":178.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":202.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":178.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":117.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":84.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":78.08,"methodology":"fee schedule"}]}]},{"description":"INJ SUBQ/IM MS","code_information":[{"code":"3426000156","type":"CDM"},{"code":"0940","type":"RC"}],"standard_charges":[{"minimum":68.8,"maximum":206.4,"gross_charge":215,"discounted_cash":124.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":204.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":206.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":156.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":178.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":156.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":74.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":68.8,"methodology":"fee schedule"}]}]},{"description":"IV PUSH INITIAL/SINGLE MS SDS","code_information":[{"code":"3426000157","type":"CDM"},{"code":"0940","type":"RC"}],"standard_charges":[{"minimum":248.64,"maximum":745.92,"gross_charge":777,"discounted_cash":450.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":738.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":745.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":567.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":644.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":567.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":372.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":269.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":248.64,"methodology":"fee schedule"}]}]},{"description":"IV PUSH EA ADD DIFF RX MS","code_information":[{"code":"3426000158","type":"CDM"},{"code":"0940","type":"RC"}],"standard_charges":[{"minimum":47.36,"maximum":142.08,"gross_charge":148,"discounted_cash":85.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":140.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":51.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.36,"methodology":"fee schedule"}]}]},{"description":"IV PUSH EA ADD SAME RX MS","code_information":[{"code":"3426000159","type":"CDM"},{"code":"0940","type":"RC"}],"standard_charges":[{"minimum":35.84,"maximum":107.52,"gross_charge":112,"discounted_cash":64.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":106.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":107.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":81.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":92.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":81.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":53.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":38.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":35.84,"methodology":"fee schedule"}]}]},{"description":"INJ SUBQ/IM CLIN","code_information":[{"code":"3426020000","type":"CDM"},{"code":"0260","type":"RC"}],"standard_charges":[{"minimum":13.12,"maximum":39.36,"gross_charge":41,"discounted_cash":23.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.12,"methodology":"fee schedule"}]}]},{"description":"OXYGEN DAILY CHARGE","code_information":[{"code":"3427010105","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":125.76,"maximum":377.28,"gross_charge":393,"discounted_cash":227.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":373.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":377.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":286.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":326.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":286.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":188.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":136.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":125.76,"methodology":"fee schedule"}]}]},{"description":"RT-COMPRESSED AIR/HR","code_information":[{"code":"3427100001","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":6.72,"maximum":20.16,"gross_charge":21,"discounted_cash":12.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":19.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":20.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":15.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":17.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":15.33,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":10.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC ADJ DPTH 2.5X12-26M","code_information":[{"code":"342804","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":926.37,"maximum":1218.24,"gross_charge":1269,"discounted_cash":736.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1205.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1218.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":926.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1053.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":926.37,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC ADJ DPTH 2.5X12-26M","code_information":[{"code":"342804","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":406.08,"maximum":1218.24,"gross_charge":1269,"discounted_cash":736.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1205.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1218.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":926.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1053.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":926.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":609.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":440.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":406.08,"methodology":"fee schedule"}]}]},{"description":"PIN TEMP DRVR","code_information":[{"code":"342826","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":251.85,"maximum":331.2,"gross_charge":345,"discounted_cash":200.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":327.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":331.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":251.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":286.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":251.85,"methodology":"fee schedule"}]}]},{"description":"PIN TEMP DRVR","code_information":[{"code":"342826","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":110.4,"maximum":331.2,"gross_charge":345,"discounted_cash":200.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":327.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":331.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":251.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":286.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":251.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":165.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":110.4,"methodology":"fee schedule"}]}]},{"description":"SEV ACUTE RESP & FLU A&B CLI","code_information":[{"code":"3430066624","type":"CDM"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":67.52,"maximum":202.56,"gross_charge":211,"discounted_cash":122.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":200.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":202.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":154.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":175.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":154.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":101.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":73.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":67.52,"methodology":"fee schedule"}]}]},{"description":"STREP GROUP A RAPID CLIA CLI","code_information":[{"code":"3430066625","type":"CDM"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":16,"maximum":48,"gross_charge":50,"discounted_cash":29,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":47.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":36.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":36.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":17.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16,"methodology":"fee schedule"}]}]},{"description":"MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY","code_information":[{"code":"3431","type":"APR-DRG"}],"standard_charges":[{"minimum":18305,"maximum":18305,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18305,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY","code_information":[{"code":"3432","type":"APR-DRG"}],"standard_charges":[{"minimum":25171,"maximum":25171,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25171,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EPIDURAL CERV OR THORACIC INJ","code_information":[{"code":"3432000130","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":845.76,"maximum":2537.28,"gross_charge":2643,"discounted_cash":1532.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2510.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2537.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1929.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2193.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1929.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1268.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":916.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":845.76,"methodology":"fee schedule"}]}]},{"description":"ASP/INJ SMALL JOINT/BURSA","code_information":[{"code":"3432000134","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":262.4,"maximum":787.2,"gross_charge":820,"discounted_cash":475.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":779,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":787.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":598.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":680.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":598.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":393.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":284.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":262.4,"methodology":"fee schedule"}]}]},{"description":"SANFORD INPT XRAY PROC","code_information":[{"code":"3432000137","type":"CDM"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":915.2,"maximum":2745.6,"gross_charge":2860,"discounted_cash":1658.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2717,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2745.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2087.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2373.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2087.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1372.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":991.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":915.2,"methodology":"fee schedule"}]}]},{"description":"MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY","code_information":[{"code":"3433","type":"APR-DRG"}],"standard_charges":[{"minimum":36630,"maximum":36630,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36630,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHEMO SUBQ IM NON-HORMO","code_information":[{"code":"3433100001","type":"CDM"},{"code":"0331","type":"RC"}],"standard_charges":[{"minimum":71.68,"maximum":215.04,"gross_charge":224,"discounted_cash":129.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":212.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":215.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":163.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":185.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":163.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":107.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":77.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":71.68,"methodology":"fee schedule"}]}]},{"description":"CHEMO ADMIN INTRA-LESION","code_information":[{"code":"3433100003","type":"CDM"},{"code":"0331","type":"RC"}],"standard_charges":[{"minimum":72.32,"maximum":216.96,"gross_charge":226,"discounted_cash":131.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":214.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":216.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":164.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":187.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":164.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.32,"methodology":"fee schedule"}]}]},{"description":"CHEMO IVP-SDC","code_information":[{"code":"3433100004","type":"CDM"},{"code":"0331","type":"RC"}],"standard_charges":[{"minimum":248.64,"maximum":745.92,"gross_charge":777,"discounted_cash":450.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":738.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":745.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":567.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":644.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":567.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":372.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":269.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":248.64,"methodology":"fee schedule"}]}]},{"description":"IV PUSH CHEMO EA ADDL RX ACU","code_information":[{"code":"3433100006","type":"CDM"},{"code":"0331","type":"RC"}],"standard_charges":[{"minimum":143.04,"maximum":429.12,"gross_charge":447,"discounted_cash":259.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":424.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":429.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":326.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":371.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":326.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":214.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":155.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":143.04,"methodology":"fee schedule"}]}]},{"description":"IV INF CHEMO 16-90M ACU","code_information":[{"code":"3433500001","type":"CDM"},{"code":"0335","type":"RC"}],"standard_charges":[{"minimum":386.56,"maximum":1159.68,"gross_charge":1208,"discounted_cash":700.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1147.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1159.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":881.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1002.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":881.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":579.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":418.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":386.56,"methodology":"fee schedule"}]}]},{"description":"IV INF CHEMO EA ADD (91M+) ACU","code_information":[{"code":"3433500002","type":"CDM"},{"code":"0335","type":"RC"}],"standard_charges":[{"minimum":75.2,"maximum":225.6,"gross_charge":235,"discounted_cash":136.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":223.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":225.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":171.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":195.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":171.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":112.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":81.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":75.2,"methodology":"fee schedule"}]}]},{"description":"IV INF CHEMO EA ADD SEQ 91+ACU","code_information":[{"code":"3433500004","type":"CDM"},{"code":"0335","type":"RC"}],"standard_charges":[{"minimum":120.64,"maximum":361.92,"gross_charge":377,"discounted_cash":218.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":358.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":361.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":275.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":312.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":275.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":180.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":130.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":120.64,"methodology":"fee schedule"}]}]},{"description":"MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY","code_information":[{"code":"3434","type":"APR-DRG"}],"standard_charges":[{"minimum":51269,"maximum":51269,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":51269,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INJ ARTHROGRAM SHOULDER ACU","code_information":[{"code":"3436000013","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":95.36,"maximum":286.08,"gross_charge":298,"discounted_cash":172.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":283.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":286.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":217.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":247.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":217.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":143.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":103.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":95.36,"methodology":"fee schedule"}]}]},{"description":"ILEOSCOPY VIA STOMA","code_information":[{"code":"3436000261","type":"CDM"},{"code":"0750","type":"RC"}],"standard_charges":[{"minimum":1174.4,"maximum":3523.2,"gross_charge":3670,"discounted_cash":2128.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3486.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3523.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2679.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3046.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2679.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1761.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1272.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1174.4,"methodology":"fee schedule"}]}]},{"description":"TREAT SPINE PROCESS FX","code_information":[{"code":"3436010130","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":327.04,"maximum":430.08,"gross_charge":448,"discounted_cash":259.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":425.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":430.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":327.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":371.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":327.04,"methodology":"fee schedule"}]}]},{"description":"TREAT SPINE PROCESS FX","code_information":[{"code":"3436010130","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":143.36,"maximum":430.08,"gross_charge":448,"discounted_cash":259.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":425.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":430.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":327.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":371.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":327.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":215.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":155.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":143.36,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 FIRST 30 MINS","code_information":[{"code":"3436010135","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2371.77,"maximum":3119.04,"gross_charge":3249,"discounted_cash":1884.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3086.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3119.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2371.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2696.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2371.77,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 FIRST 30 MINS","code_information":[{"code":"3436010135","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1039.68,"maximum":3119.04,"gross_charge":3249,"discounted_cash":1884.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3086.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3119.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2371.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2696.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2371.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1559.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1126.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1039.68,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 ADDL 15 MINS","code_information":[{"code":"3436010140","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":240.17,"maximum":315.84,"gross_charge":329,"discounted_cash":190.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":312.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":315.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.17,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 ADDL 15 MINS","code_information":[{"code":"3436010140","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":105.28,"maximum":315.84,"gross_charge":329,"discounted_cash":190.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":312.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":315.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":157.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":114.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":105.28,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 FIRST 30 MINS","code_information":[{"code":"3436010145","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":3341.21,"maximum":4393.92,"gross_charge":4577,"discounted_cash":2654.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4348.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4393.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3341.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3798.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3341.21,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 FIRST 30 MINS","code_information":[{"code":"3436010145","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1464.64,"maximum":4393.92,"gross_charge":4577,"discounted_cash":2654.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4348.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4393.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3341.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3798.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3341.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2196.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1587.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1464.64,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 ADDL 15 MINS","code_information":[{"code":"3436010150","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":336.53,"maximum":442.56,"gross_charge":461,"discounted_cash":267.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":437.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":442.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":336.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":382.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":336.53,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 ADDL 15 MINS","code_information":[{"code":"3436010150","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":147.52,"maximum":442.56,"gross_charge":461,"discounted_cash":267.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":437.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":442.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":336.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":382.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":336.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":221.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":159.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":147.52,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 FIRST 30 MINS","code_information":[{"code":"3436010155","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":4634.77,"maximum":6095.04,"gross_charge":6349,"discounted_cash":3682.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6031.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6095.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4634.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5269.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4634.77,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 FIRST 30 MINS","code_information":[{"code":"3436010155","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2031.68,"maximum":6095.04,"gross_charge":6349,"discounted_cash":3682.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6031.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6095.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4634.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5269.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4634.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3047.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2201.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2031.68,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 ADDL 15 MINS","code_information":[{"code":"3436010160","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":466.47,"maximum":613.44,"gross_charge":639,"discounted_cash":370.62,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":607.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":613.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":466.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":530.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":466.47,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 ADDL 15 MINS","code_information":[{"code":"3436010160","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":204.48,"maximum":613.44,"gross_charge":639,"discounted_cash":370.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":607.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":613.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":466.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":530.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":466.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":306.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":221.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":204.48,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 FIRST 30 MINS","code_information":[{"code":"3436010165","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":6464.88,"maximum":8501.76,"gross_charge":8856,"discounted_cash":5136.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8413.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8501.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6464.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7350.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6464.88,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 FIRST 30 MINS","code_information":[{"code":"3436010165","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2833.92,"maximum":8501.76,"gross_charge":8856,"discounted_cash":5136.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8413.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8501.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6464.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7350.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6464.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4250.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3071.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2833.92,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 ADDL 15 MINS","code_information":[{"code":"3436010170","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":648.24,"maximum":852.48,"gross_charge":888,"discounted_cash":515.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":843.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":852.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":648.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":737.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":648.24,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 ADDL 15 MINS","code_information":[{"code":"3436010170","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":284.16,"maximum":852.48,"gross_charge":888,"discounted_cash":515.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":843.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":852.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":648.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":737.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":648.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":426.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":307.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":284.16,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 FIRST 30 MINS","code_information":[{"code":"3436010175","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":7677.41,"maximum":10096.32,"gross_charge":10517,"discounted_cash":6099.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":9991.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":10096.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7677.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8729.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7677.41,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 FIRST 30 MINS","code_information":[{"code":"3436010175","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":3365.44,"maximum":10096.32,"gross_charge":10517,"discounted_cash":6099.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":9991.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":10096.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7677.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":8729.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7677.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5048.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3647.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3365.44,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 ADDL 15 MINS","code_information":[{"code":"3436010180","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":767.96,"maximum":1009.92,"gross_charge":1052,"discounted_cash":610.16,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":999.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1009.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":767.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":873.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":767.96,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 ADDL 15 MINS","code_information":[{"code":"3436010180","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":336.64,"maximum":1009.92,"gross_charge":1052,"discounted_cash":610.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":999.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1009.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":767.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":873.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":767.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":504.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":364.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":336.64,"methodology":"fee schedule"}]}]},{"description":"CHANGE GASTROSTOMY TUBE","code_information":[{"code":"3436100006","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":290.56,"maximum":871.68,"gross_charge":908,"discounted_cash":526.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":862.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":871.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":662.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":753.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":662.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":435.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":314.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":290.56,"methodology":"fee schedule"}]}]},{"description":"CLOSED TRMT RIB FX","code_information":[{"code":"3436100008","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":151.68,"maximum":455.04,"gross_charge":474,"discounted_cash":274.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":450.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":455.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":346.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":393.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":346.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":227.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":164.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":151.68,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF SCROTUM","code_information":[{"code":"3436100009","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1649.6,"maximum":4948.8,"gross_charge":5155,"discounted_cash":2989.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4897.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4948.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3763.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4278.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3763.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2474.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1787.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1649.6,"methodology":"fee schedule"}]}]},{"description":"REM TUNNELED CVC WO PMP ACU","code_information":[{"code":"3436100050","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":720.96,"maximum":2162.88,"gross_charge":2253,"discounted_cash":1306.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2140.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2162.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1644.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1869.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1644.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1081.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":781.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":720.96,"methodology":"fee schedule"}]}]},{"description":"THORACENTESIS W IMAGING ACU","code_information":[{"code":"3436100070","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":535.36,"maximum":1606.08,"gross_charge":1673,"discounted_cash":970.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1589.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1606.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1221.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1388.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1221.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":803.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":580.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":535.36,"methodology":"fee schedule"}]}]},{"description":"DECLOT VASC DEVICE W THROM ACU","code_information":[{"code":"3436110150","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":279.68,"maximum":839.04,"gross_charge":874,"discounted_cash":506.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":830.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":839.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":638.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":725.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":638.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":419.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":303.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":279.68,"methodology":"fee schedule"}]}]},{"description":"CHANGE CYSTOSTOMY TUBE MS","code_information":[{"code":"3436110155","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":234.88,"maximum":704.64,"gross_charge":734,"discounted_cash":425.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":697.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":704.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":535.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":609.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":535.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":352.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":254.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":234.88,"methodology":"fee schedule"}]}]},{"description":"ABD PARACENTESIS W/O GUIDE ACU","code_information":[{"code":"3436110200","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":477.76,"maximum":1433.28,"gross_charge":1493,"discounted_cash":865.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1418.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1433.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1089.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1239.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1089.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":716.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":517.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":477.76,"methodology":"fee schedule"}]}]},{"description":"MOD SEDATION =>5YRS 1ST 15 MIN","code_information":[{"code":"3437000010","type":"CDM"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":21.76,"maximum":65.28,"gross_charge":68,"discounted_cash":39.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":64.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":65.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":49.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":56.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":49.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":32.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":23.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":21.76,"methodology":"fee schedule"}]}]},{"description":"SDC MOD SED 1ST 15 MINS>5 YRS","code_information":[{"code":"3437000011","type":"CDM"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":170.24,"maximum":510.72,"gross_charge":532,"discounted_cash":308.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":505.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":510.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":388.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":441.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":388.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":255.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":184.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":170.24,"methodology":"fee schedule"}]}]},{"description":"MOD SEDATION EA ADDL 15M ER","code_information":[{"code":"3437000355","type":"CDM"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":165.12,"maximum":495.36,"gross_charge":516,"discounted_cash":299.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":490.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":495.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":428.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":247.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":178.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":165.12,"methodology":"fee schedule"}]}]},{"description":"MOD SEDATION 1ST 15M < 5YRS ER","code_information":[{"code":"3437010100","type":"CDM"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":105.28,"maximum":315.84,"gross_charge":329,"discounted_cash":190.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":312.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":315.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":157.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":114.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":105.28,"methodology":"fee schedule"}]}]},{"description":"SPLNT ORTH GLS PRECUT 6X30IN","code_information":[{"code":"344062","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":52.56,"maximum":69.12,"gross_charge":72,"discounted_cash":41.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":68.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":69.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":52.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":59.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":52.56,"methodology":"fee schedule"}]}]},{"description":"SPLNT ORTH GLS PRECUT 6X30IN","code_information":[{"code":"344062","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":23.04,"maximum":69.12,"gross_charge":72,"discounted_cash":41.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":68.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":69.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":52.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":59.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":52.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":34.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":24.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":23.04,"methodology":"fee schedule"}]}]},{"description":"OSTEOMYELITIS SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS","code_information":[{"code":"3441","type":"APR-DRG"}],"standard_charges":[{"minimum":15442,"maximum":15442,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15442,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CPAP MANAGEMENT","code_information":[{"code":"3441000001","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":126.4,"maximum":379.2,"gross_charge":395,"discounted_cash":229.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":375.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":379.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":288.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":327.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":288.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":136.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":126.4,"methodology":"fee schedule"}]}]},{"description":"VENT ASSIST & MGMT INIT","code_information":[{"code":"3441000002","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":291.2,"maximum":873.6,"gross_charge":910,"discounted_cash":527.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":864.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":873.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":664.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":755.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":664.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":436.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":315.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":291.2,"methodology":"fee schedule"}]}]},{"description":"VENT ASSIST & MGMT SUBS","code_information":[{"code":"3441000003","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":219.84,"maximum":659.52,"gross_charge":687,"discounted_cash":398.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":652.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":659.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":501.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":570.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":501.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":329.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":238.26,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":219.84,"methodology":"fee schedule"}]}]},{"description":"MDI/NEBULIZER SMALL VOL RT","code_information":[{"code":"3441000004","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":39.68,"maximum":119.04,"gross_charge":124,"discounted_cash":71.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":117.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":102.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":43.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":39.68,"methodology":"fee schedule"}]}]},{"description":"CHEST WALL MANIPUL SUBS","code_information":[{"code":"3441000006","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":62.72,"maximum":188.16,"gross_charge":196,"discounted_cash":113.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":186.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":188.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":143.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":162.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":143.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":94.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":67.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":62.72,"methodology":"fee schedule"}]}]},{"description":"CHEST WALL MANIPUL INIT","code_information":[{"code":"3441000007","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":57.28,"maximum":171.84,"gross_charge":179,"discounted_cash":103.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":170.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":171.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":130.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":148.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":130.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":62.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":57.28,"methodology":"fee schedule"}]}]},{"description":"DEMO/EVAL OF PT UTILIZATION","code_information":[{"code":"3441000008","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":43.2,"maximum":129.6,"gross_charge":135,"discounted_cash":78.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":128.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":129.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":98.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":112.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":98.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":64.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":46.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":43.2,"methodology":"fee schedule"}]}]},{"description":"MECH CHEST WALL OSCILLATION","code_information":[{"code":"3441000009","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":68.8,"maximum":206.4,"gross_charge":215,"discounted_cash":124.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":204.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":206.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":156.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":178.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":156.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":74.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":68.8,"methodology":"fee schedule"}]}]},{"description":"CONT INHALATION TRMT 1ST HR","code_information":[{"code":"3441000063","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":95.36,"maximum":286.08,"gross_charge":298,"discounted_cash":172.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":283.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":286.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":217.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":247.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":217.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":143.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":103.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":95.36,"methodology":"fee schedule"}]}]},{"description":"CONT INHALATION TRMTADDL HRS","code_information":[{"code":"3441000064","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":34.24,"maximum":102.72,"gross_charge":107,"discounted_cash":62.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":101.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":102.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":78.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":88.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":78.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":37.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":34.24,"methodology":"fee schedule"}]}]},{"description":"CLEARANCE OF AIRWAY","code_information":[{"code":"3441000065","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":176.32,"maximum":528.96,"gross_charge":551,"discounted_cash":319.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":523.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":528.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":402.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":457.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":402.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":264.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":191.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":176.32,"methodology":"fee schedule"}]}]},{"description":"OSTEOMYELITIS SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS","code_information":[{"code":"3442","type":"APR-DRG"}],"standard_charges":[{"minimum":24240,"maximum":24240,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24240,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ONE MONTH FITNESS MEMBERS","code_information":[{"code":"3442000002","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":27.84,"maximum":83.52,"gross_charge":87,"discounted_cash":50.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":82.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":83.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":63.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":72.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":63.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":41.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":30.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":27.84,"methodology":"fee schedule"}]}]},{"description":"LOW BACK STRAPPING","code_information":[{"code":"3442000003","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":91.84,"maximum":275.52,"gross_charge":287,"discounted_cash":166.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":272.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":275.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":209.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":238.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":209.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":137.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":99.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":91.84,"methodology":"fee schedule"}]}]},{"description":"ANKLE STRAPPING","code_information":[{"code":"3442000004","type":"CDM"},{"code":"0490","type":"RC"}],"standard_charges":[{"minimum":145.6,"maximum":436.8,"gross_charge":455,"discounted_cash":263.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":432.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":436.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":332.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":377.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":332.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":157.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":145.6,"methodology":"fee schedule"}]}]},{"description":"HOT/COLD PACK THERAPY PT","code_information":[{"code":"3442000005","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":9.28,"maximum":27.84,"gross_charge":29,"discounted_cash":16.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":27.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":13.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.28,"methodology":"fee schedule"}]}]},{"description":"ELECTRICAL STIMULATION","code_information":[{"code":"3442000007","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":21.12,"maximum":63.36,"gross_charge":66,"discounted_cash":38.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":62.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":63.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":48.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":54.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":48.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":31.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":22.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":21.12,"methodology":"fee schedule"}]}]},{"description":"MECHANICAL TRACTION","code_information":[{"code":"3442000009","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":21.44,"maximum":64.32,"gross_charge":67,"discounted_cash":38.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":63.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":64.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":48.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":48.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":32.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":23.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":21.44,"methodology":"fee schedule"}]}]},{"description":"MASSAGE/15 MIN","code_information":[{"code":"3442000010","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":39.68,"maximum":119.04,"gross_charge":124,"discounted_cash":71.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":117.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":102.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":43.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":39.68,"methodology":"fee schedule"}]}]},{"description":"PARAFFIN BATH","code_information":[{"code":"3442000011","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":10.24,"maximum":30.72,"gross_charge":32,"discounted_cash":18.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":30.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":30.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":23.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":23.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":11.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":10.24,"methodology":"fee schedule"}]}]},{"description":"IONTOPHORESIS/15 MIN","code_information":[{"code":"3442000012","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":30.4,"maximum":91.2,"gross_charge":95,"discounted_cash":55.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":90.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":91.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":69.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":78.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":69.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":45.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":30.4,"methodology":"fee schedule"}]}]},{"description":"ULTRASOUND/15 MIN","code_information":[{"code":"3442000013","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":19.84,"maximum":59.52,"gross_charge":62,"discounted_cash":35.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":58.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":59.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":45.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":51.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":45.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":29.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":21.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":19.84,"methodology":"fee schedule"}]}]},{"description":"INTL ORTHODIC ENCNTR EA 15 MIN","code_information":[{"code":"3442000015","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":65.28,"maximum":195.84,"gross_charge":204,"discounted_cash":118.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":193.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":195.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":148.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":169.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":148.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":97.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":70.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":65.28,"methodology":"fee schedule"}]}]},{"description":"COMM WORK REINTEG/15 MINS","code_information":[{"code":"3442000017","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":45.12,"maximum":135.36,"gross_charge":141,"discounted_cash":81.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":133.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":135.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":102.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":117.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":102.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":48.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":45.12,"methodology":"fee schedule"}]}]},{"description":"WHEELCHAIR MNGT TRAIN/15 MIN","code_information":[{"code":"3442000018","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":45.76,"maximum":137.28,"gross_charge":143,"discounted_cash":82.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":135.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":137.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":104.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":118.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":104.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":49.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":45.76,"methodology":"fee schedule"}]}]},{"description":"WORK HARDENING INIT 2 HR","code_information":[{"code":"3442000019","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":121.92,"maximum":365.76,"gross_charge":381,"discounted_cash":220.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":361.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":365.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":278.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":316.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":278.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":182.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":132.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":121.92,"methodology":"fee schedule"}]}]},{"description":"PHYS PERF TEST/15 MIN","code_information":[{"code":"3442000020","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":48,"maximum":144,"gross_charge":150,"discounted_cash":87,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":142.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":52.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":48,"methodology":"fee schedule"}]}]},{"description":"THERAPEUTIC EXER (15 MIN)","code_information":[{"code":"3442000022","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":44.8,"maximum":134.4,"gross_charge":140,"discounted_cash":81.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":133,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":134.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":102.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":116.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":102.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":48.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":44.8,"methodology":"fee schedule"}]}]},{"description":"NEURO REEDUC TRAIN/15 MIN","code_information":[{"code":"3442000023","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":50.88,"maximum":152.64,"gross_charge":159,"discounted_cash":92.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":151.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":55.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":50.88,"methodology":"fee schedule"}]}]},{"description":"THERAP ACTIVE PERF/15 MIN","code_information":[{"code":"3442000024","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":54.08,"maximum":162.24,"gross_charge":169,"discounted_cash":98.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":160.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":162.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":123.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":140.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":123.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":81.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":58.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":54.08,"methodology":"fee schedule"}]}]},{"description":"VAC DRESSING <50CM","code_information":[{"code":"3442000025","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":59.52,"maximum":178.56,"gross_charge":186,"discounted_cash":107.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":176.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":178.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":154.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":135.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":89.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":64.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":59.52,"methodology":"fee schedule"}]}]},{"description":"VAC DRESSING >50CM","code_information":[{"code":"3442000026","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":69.44,"maximum":208.32,"gross_charge":217,"discounted_cash":125.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":206.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":208.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":158.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":158.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":104.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":75.26,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":69.44,"methodology":"fee schedule"}]}]},{"description":"NON SELECTIVE WOUND CARE","code_information":[{"code":"3442000027","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":131.2,"maximum":393.6,"gross_charge":410,"discounted_cash":237.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":389.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":393.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":299.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":340.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":299.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":196.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":142.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":131.2,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE EA ADDL 20 SQ CM< PT","code_information":[{"code":"3442000028","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":41.28,"maximum":123.84,"gross_charge":129,"discounted_cash":74.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":122.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":123.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":94.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":107.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":94.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":61.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":44.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":41.28,"methodology":"fee schedule"}]}]},{"description":"GAIT TRAINING/15 MIN","code_information":[{"code":"3442000029","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":40.96,"maximum":122.88,"gross_charge":128,"discounted_cash":74.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":121.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":122.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":93.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":106.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":93.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":61.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":44.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":40.96,"methodology":"fee schedule"}]}]},{"description":"PT TRMT-UNLISTED MODALITY-15MI","code_information":[{"code":"3442000030","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":17.6,"maximum":52.8,"gross_charge":55,"discounted_cash":31.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":52.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":52.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":45.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":17.6,"methodology":"fee schedule"}]}]},{"description":"PHYS MEDICENE PROC","code_information":[{"code":"3442000031","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":22.08,"maximum":66.24,"gross_charge":69,"discounted_cash":40.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":65.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":66.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":50.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":57.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":50.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":33.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":23.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"}]}]},{"description":"WHIRLPOOL","code_information":[{"code":"3442000032","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":25.92,"maximum":77.76,"gross_charge":81,"discounted_cash":46.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":76.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":77.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":59.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":59.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":28.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":25.92,"methodology":"fee schedule"}]}]},{"description":"SELFCARE-HOME MGMT/15 MIN","code_information":[{"code":"3442000033","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":47.04,"maximum":141.12,"gross_charge":147,"discounted_cash":85.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":139.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":141.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":107.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":107.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":70.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":50.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.04,"methodology":"fee schedule"}]}]},{"description":"MANUAL THERAPY/15 MIN","code_information":[{"code":"3442000034","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":40.64,"maximum":121.92,"gross_charge":127,"discounted_cash":73.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":120.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":121.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":92.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":105.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":92.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":60.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":44.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":40.64,"methodology":"fee schedule"}]}]},{"description":"VASOPHNEUMATIC DEVICE THE","code_information":[{"code":"3442000035","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":18.56,"maximum":55.68,"gross_charge":58,"discounted_cash":33.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":55.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":55.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":42.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":42.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":27.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":20.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.56,"methodology":"fee schedule"}]}]},{"description":"INTL PROST ENCOUNTER EA 15 MIN","code_information":[{"code":"3442000036","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":56.32,"maximum":168.96,"gross_charge":176,"discounted_cash":102.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":167.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":168.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":128.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":146.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":128.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":84.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":61.04,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":56.32,"methodology":"fee schedule"}]}]},{"description":"SELECTIVE WOUND CARE","code_information":[{"code":"3442000037","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":179.2,"maximum":537.6,"gross_charge":560,"discounted_cash":324.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":532,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":537.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":408.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":464.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":408.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":268.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":194.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":179.2,"methodology":"fee schedule"}]}]},{"description":"APPLICATION OF UNNA BOOT","code_information":[{"code":"3442000042","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":85.12,"maximum":255.36,"gross_charge":266,"discounted_cash":154.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":252.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":255.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":194.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":220.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":194.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":127.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":92.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":85.12,"methodology":"fee schedule"}]}]},{"description":"ORTHO/PRO ADD ENCOUNTER 15 MIN","code_information":[{"code":"3442000250","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":82.88,"maximum":248.64,"gross_charge":259,"discounted_cash":150.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":246.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":248.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":189.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":214.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":189.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":124.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":89.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":82.88,"methodology":"fee schedule"}]}]},{"description":"DRY NEEDLING CASH ONLY INITIAL","code_information":[{"code":"3442011110","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":19.2,"maximum":57.6,"gross_charge":60,"discounted_cash":34.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":57.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":43.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":49.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":43.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":28.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":20.81,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"}]}]},{"description":"DRY NEEDLING CASH ONLY SUBSEQ","code_information":[{"code":"3442011115","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":9.6,"maximum":28.8,"gross_charge":30,"discounted_cash":17.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":28.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":28.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":14.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.6,"methodology":"fee schedule"}]}]},{"description":"APPLICATION OF UNNA BOOT BILAT","code_information":[{"code":"3442029580","type":"CDM"},{"code":"0420","type":"RC"}],"standard_charges":[{"minimum":123.52,"maximum":370.56,"gross_charge":386,"discounted_cash":223.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":366.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":370.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":281.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":320.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":281.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":185.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":133.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":123.52,"methodology":"fee schedule"}]}]},{"description":"PT EVAL LOW COMPLEX","code_information":[{"code":"3442400011","type":"CDM"},{"code":"0424","type":"RC"}],"standard_charges":[{"minimum":122.56,"maximum":367.68,"gross_charge":383,"discounted_cash":222.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":363.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":367.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":279.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":317.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":279.59,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":183.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":132.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":122.56,"methodology":"fee schedule"}]}]},{"description":"PT RE-EVAL ESTAB PLAN","code_information":[{"code":"3442400014","type":"CDM"},{"code":"0424","type":"RC"}],"standard_charges":[{"minimum":83.2,"maximum":249.6,"gross_charge":260,"discounted_cash":150.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":247,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":249.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":189.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":215.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":189.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":124.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":90.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":83.2,"methodology":"fee schedule"}]}]},{"description":"OSTEOMYELITIS SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS","code_information":[{"code":"3443","type":"APR-DRG"}],"standard_charges":[{"minimum":28186,"maximum":28186,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28186,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SELF CARE MGMT TRAINING-PER 15","code_information":[{"code":"3443000001","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":55.36,"maximum":166.08,"gross_charge":173,"discounted_cash":100.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":164.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":166.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":126.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":143.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":126.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":83.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":60,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":55.36,"methodology":"fee schedule"}]}]},{"description":"MANUAL THERAPY-PER 15 MIN","code_information":[{"code":"3443000002","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":47.68,"maximum":143.04,"gross_charge":149,"discounted_cash":86.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":141.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":143.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":123.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":51.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.68,"methodology":"fee schedule"}]}]},{"description":"EXERCISE THERAPEUTIC-PER 15 MI","code_information":[{"code":"3443000003","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":51.84,"maximum":155.52,"gross_charge":162,"discounted_cash":93.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":153.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":155.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":118.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":134.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":118.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":56.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":51.84,"methodology":"fee schedule"}]}]},{"description":"THERAPEUTIC ACTIVITY-PER 15 MI","code_information":[{"code":"3443000004","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":63.36,"maximum":190.08,"gross_charge":198,"discounted_cash":114.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":188.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":190.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":164.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":95.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":68.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":63.36,"methodology":"fee schedule"}]}]},{"description":"SENSORY INTEGRATION 15 MI","code_information":[{"code":"3443000006","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":68.48,"maximum":205.44,"gross_charge":214,"discounted_cash":124.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":203.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":205.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":156.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":177.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":156.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":102.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":74.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":68.48,"methodology":"fee schedule"}]}]},{"description":"NEUROMUSCULAR RE-EDUC-PER 15 M","code_information":[{"code":"3443000007","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":58.88,"maximum":176.64,"gross_charge":184,"discounted_cash":106.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":174.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":176.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":134.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":152.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":134.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":88.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":63.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":58.88,"methodology":"fee schedule"}]}]},{"description":"WOUND DEBRIDEMENT SELECT","code_information":[{"code":"3443000008","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":150.4,"maximum":451.2,"gross_charge":470,"discounted_cash":272.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":446.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":451.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":343.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":390.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":343.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":225.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":163,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":150.4,"methodology":"fee schedule"}]}]},{"description":"INTL ORTHODIC ENCNTR EA 15 MIN","code_information":[{"code":"3443000009","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":76.16,"maximum":228.48,"gross_charge":238,"discounted_cash":138.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":226.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":228.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":173.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":197.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":173.74,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":114.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":82.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":76.16,"methodology":"fee schedule"}]}]},{"description":"ROM","code_information":[{"code":"3443000012","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":33.6,"maximum":100.8,"gross_charge":105,"discounted_cash":60.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":99.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":100.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":76.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":87.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":76.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":50.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":36.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":33.6,"methodology":"fee schedule"}]}]},{"description":"ROM OF HAND","code_information":[{"code":"3443000013","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":30.4,"maximum":91.2,"gross_charge":95,"discounted_cash":55.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":90.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":91.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":69.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":78.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":69.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":45.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":30.4,"methodology":"fee schedule"}]}]},{"description":"HOME SAFETY EVAL-15 MIN","code_information":[{"code":"3443000016","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":61.44,"maximum":184.32,"gross_charge":192,"discounted_cash":111.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":182.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":184.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":140.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":159.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":92.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":66.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":61.44,"methodology":"fee schedule"}]}]},{"description":"NEUROBEHAVORIAL STAT EX-PER HR","code_information":[{"code":"3443000017","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":152.64,"maximum":457.92,"gross_charge":477,"discounted_cash":276.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":453.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":457.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":348.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":395.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":348.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":228.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":165.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"}]}]},{"description":"PARAFFIN BATH","code_information":[{"code":"3443000018","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":11.84,"maximum":35.52,"gross_charge":37,"discounted_cash":21.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":35.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":35.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":27.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":30.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":27.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":17.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":12.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":11.84,"methodology":"fee schedule"}]}]},{"description":"CONTRAST BATHS-PER 15 MIN","code_information":[{"code":"3443000019","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":24.96,"maximum":74.88,"gross_charge":78,"discounted_cash":45.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":74.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":74.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":56.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":64.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":56.94,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":37.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":27.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":24.96,"methodology":"fee schedule"}]}]},{"description":"ULTRASOUND-PER 15 MIN","code_information":[{"code":"3443000020","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":23.04,"maximum":69.12,"gross_charge":72,"discounted_cash":41.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":68.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":69.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":52.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":59.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":52.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":34.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":24.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":23.04,"methodology":"fee schedule"}]}]},{"description":"UNLISTED PROC/SPECIFIC","code_information":[{"code":"3443000022","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":26.56,"maximum":79.68,"gross_charge":83,"discounted_cash":48.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":78.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":60.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":60.59,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":28.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":26.56,"methodology":"fee schedule"}]}]},{"description":"INTL PROST ENCOUNTER EA 15 MIN","code_information":[{"code":"3443000024","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":65.6,"maximum":196.8,"gross_charge":205,"discounted_cash":118.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":194.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":196.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":149.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":170.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":149.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":71.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":65.6,"methodology":"fee schedule"}]}]},{"description":"COMM REINTEG/15MIN","code_information":[{"code":"3443000026","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":52.8,"maximum":158.4,"gross_charge":165,"discounted_cash":95.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":156.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":158.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":120.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":136.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":120.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":57.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":52.8,"methodology":"fee schedule"}]}]},{"description":"WORKHARDENING INIT/2HR","code_information":[{"code":"3443000027","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":81.92,"maximum":245.76,"gross_charge":256,"discounted_cash":148.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":243.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":245.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":186.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":212.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":186.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":122.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":88.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":81.92,"methodology":"fee schedule"}]}]},{"description":"WARKHARDENING ADD/HR**","code_information":[{"code":"3443000028","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":74.56,"maximum":223.68,"gross_charge":233,"discounted_cash":135.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":221.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":223.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":170.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":193.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":170.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":111.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":80.81,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":74.56,"methodology":"fee schedule"}]}]},{"description":"WOUND DEBRIDEMENT-NON SELECTIV","code_information":[{"code":"3443000029","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":152.96,"maximum":458.88,"gross_charge":478,"discounted_cash":277.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":454.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":458.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":348.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":396.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":348.94,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":229.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":165.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":152.96,"methodology":"fee schedule"}]}]},{"description":"PHYS PERFORM TEST/15MIN","code_information":[{"code":"3443000031","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":55.68,"maximum":167.04,"gross_charge":174,"discounted_cash":100.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":165.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":167.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":127.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":144.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":127.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":83.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":60.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":55.68,"methodology":"fee schedule"}]}]},{"description":"DEVELOP COG SKILLS 1ST 15 MIN","code_information":[{"code":"3443010100","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":62.08,"maximum":186.24,"gross_charge":194,"discounted_cash":112.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":184.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":186.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":141.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":161.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":141.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":67.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":62.08,"methodology":"fee schedule"}]}]},{"description":"DEVELOP COG SKLLS EA ADDL 15MN","code_information":[{"code":"3443010105","type":"CDM"},{"code":"0430","type":"RC"}],"standard_charges":[{"minimum":44.16,"maximum":132.48,"gross_charge":138,"discounted_cash":80.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":131.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":132.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":100.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":114.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":100.74,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":66.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":47.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":44.16,"methodology":"fee schedule"}]}]},{"description":"OT EVAL LOW COMPLEX","code_information":[{"code":"3443400003","type":"CDM"},{"code":"0434","type":"RC"}],"standard_charges":[{"minimum":135.04,"maximum":405.12,"gross_charge":422,"discounted_cash":244.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":400.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":405.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":308.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":350.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":308.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":202.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":146.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":135.04,"methodology":"fee schedule"}]}]},{"description":"OT RE-EVAL ESTAB PLAN","code_information":[{"code":"3443400006","type":"CDM"},{"code":"0434","type":"RC"}],"standard_charges":[{"minimum":92.8,"maximum":278.4,"gross_charge":290,"discounted_cash":168.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":275.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":278.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":211.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":240.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":211.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":139.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":100.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":92.8,"methodology":"fee schedule"}]}]},{"description":"OSTEOMYELITIS SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS","code_information":[{"code":"3444","type":"APR-DRG"}],"standard_charges":[{"minimum":46641,"maximum":46641,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46641,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPEECH THERAPY","code_information":[{"code":"3444000001","type":"CDM"},{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":164.48,"maximum":493.44,"gross_charge":514,"discounted_cash":298.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":488.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":493.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":375.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":426.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":375.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":246.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":178.26,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":164.48,"methodology":"fee schedule"}]}]},{"description":"SWALLOWING THERAPY","code_information":[{"code":"3444000002","type":"CDM"},{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":180.16,"maximum":540.48,"gross_charge":563,"discounted_cash":326.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":534.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":540.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":410.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":467.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":410.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":270.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":195.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":180.16,"methodology":"fee schedule"}]}]},{"description":"SPEECH/HEARING THERAPY","code_information":[{"code":"3444000100","type":"CDM"},{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":48.64,"maximum":145.92,"gross_charge":152,"discounted_cash":88.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":144.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":145.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":110.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":110.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":72.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":52.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":48.64,"methodology":"fee schedule"}]}]},{"description":"NASOPHARYNGOSCOPY","code_information":[{"code":"3444000105","type":"CDM"},{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":181.12,"maximum":543.36,"gross_charge":566,"discounted_cash":328.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":537.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":543.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":413.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":469.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":413.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":271.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":196.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":181.12,"methodology":"fee schedule"}]}]},{"description":"LARYNGEAL FUNCTION STUDIES","code_information":[{"code":"3444000110","type":"CDM"},{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":161.6,"maximum":484.8,"gross_charge":505,"discounted_cash":292.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":479.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":484.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":368.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":419.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":368.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":242.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":175.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":161.6,"methodology":"fee schedule"}]}]},{"description":"ENDOSCOPY SWALLOW TST (FEES)","code_information":[{"code":"3444000115","type":"CDM"},{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":400.32,"maximum":1200.96,"gross_charge":1251,"discounted_cash":725.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1188.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":913.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1038.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":913.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":600.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":433.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":400.32,"methodology":"fee schedule"}]}]},{"description":"LARYNGOSCOPIC SENSORY TEST","code_information":[{"code":"3444000120","type":"CDM"},{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":144.96,"maximum":434.88,"gross_charge":453,"discounted_cash":262.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":430.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":434.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":330.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":375.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":330.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":217.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":157.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":144.96,"methodology":"fee schedule"}]}]},{"description":"FEES W/LARYNGEAL SENSE TEST","code_information":[{"code":"3444000125","type":"CDM"},{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":199.36,"maximum":598.08,"gross_charge":623,"discounted_cash":361.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":591.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":598.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":454.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":517.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":454.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":299.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":216.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":199.36,"methodology":"fee schedule"}]}]},{"description":"EVAL AUD REHAB STATUS","code_information":[{"code":"3444000130","type":"CDM"},{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":188.8,"maximum":566.4,"gross_charge":590,"discounted_cash":342.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":560.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":566.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":430.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":489.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":430.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":283.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":204.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":188.8,"methodology":"fee schedule"}]}]},{"description":"EVAL AUD STATUS REHAB ADD-ON","code_information":[{"code":"3444000135","type":"CDM"},{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":48,"maximum":144,"gross_charge":150,"discounted_cash":87,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":142.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":52.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":48,"methodology":"fee schedule"}]}]},{"description":"SENSORY INTEGRATION","code_information":[{"code":"3444000140","type":"CDM"},{"code":"0440","type":"RC"}],"standard_charges":[{"minimum":72.32,"maximum":216.96,"gross_charge":226,"discounted_cash":131.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":214.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":216.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":164.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":187.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":164.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.32,"methodology":"fee schedule"}]}]},{"description":"VIDEO FLOUROSCOPY EVAL","code_information":[{"code":"3444400001","type":"CDM"},{"code":"0444","type":"RC"}],"standard_charges":[{"minimum":216.64,"maximum":649.92,"gross_charge":677,"discounted_cash":392.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":643.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":649.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":494.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":561.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":494.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":324.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":234.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":216.64,"methodology":"fee schedule"}]}]},{"description":"EVAL OF SWALLOWING FUNCTION","code_information":[{"code":"3444400003","type":"CDM"},{"code":"0444","type":"RC"}],"standard_charges":[{"minimum":266.88,"maximum":800.64,"gross_charge":834,"discounted_cash":483.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":792.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":800.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":608.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":692.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":608.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":400.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":289.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":266.88,"methodology":"fee schedule"}]}]},{"description":"EVAL OF SPEECH FLUENCY","code_information":[{"code":"3444400004","type":"CDM"},{"code":"0444","type":"RC"}],"standard_charges":[{"minimum":245.12,"maximum":735.36,"gross_charge":766,"discounted_cash":444.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":727.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":735.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":559.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":635.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":559.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":367.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":265.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":245.12,"methodology":"fee schedule"}]}]},{"description":"EVAL OF SPEECH SOUND W LANG","code_information":[{"code":"3444400006","type":"CDM"},{"code":"0444","type":"RC"}],"standard_charges":[{"minimum":414.08,"maximum":1242.24,"gross_charge":1294,"discounted_cash":750.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1229.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1242.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":944.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1074.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":944.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":621.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":448.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":414.08,"methodology":"fee schedule"}]}]},{"description":"REM FB CONJUNCT SUPERFIC ER","code_information":[{"code":"3445000001","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":134.08,"maximum":402.24,"gross_charge":419,"discounted_cash":243.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":398.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":402.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":305.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":347.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":305.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":201.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":145.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":134.08,"methodology":"fee schedule"}]}]},{"description":"SPEC FOR LAW ENFORCEMENT ER","code_information":[{"code":"3445000003","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":18.88,"maximum":56.64,"gross_charge":59,"discounted_cash":34.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":56.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":56.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":43.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":43.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":28.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":20.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.88,"methodology":"fee schedule"}]}]},{"description":"INCISION/REM FB SIMPLE ER","code_information":[{"code":"3445000004","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":287.68,"maximum":863.04,"gross_charge":899,"discounted_cash":521.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":854.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":863.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":656.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":746.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":656.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":431.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":311.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":287.68,"methodology":"fee schedule"}]}]},{"description":"I&D ABSCESS SIMPLE ER","code_information":[{"code":"3445000005","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":156.48,"maximum":469.44,"gross_charge":489,"discounted_cash":283.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":464.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":469.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":356.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":405.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":356.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":234.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":169.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":156.48,"methodology":"fee schedule"}]}]},{"description":"BX BONE MARROW NEEDLE ER","code_information":[{"code":"3445000006","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1164.8,"maximum":3494.4,"gross_charge":3640,"discounted_cash":2111.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3458,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3494.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2657.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2657.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1747.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1262.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1164.8,"methodology":"fee schedule"}]}]},{"description":"LUMBAR PUNCTURE DIAGNOSTIC ER","code_information":[{"code":"3445000008","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":683.2,"maximum":2049.6,"gross_charge":2135,"discounted_cash":1238.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2028.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2049.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1558.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1772.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1558.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1024.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":740.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":683.2,"methodology":"fee schedule"}]}]},{"description":"THORACOSTOMY W TUBE INSRT ER","code_information":[{"code":"3445000009","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":863.68,"maximum":2591.04,"gross_charge":2699,"discounted_cash":1565.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2564.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2591.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1970.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2240.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1970.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1295.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":936.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":863.68,"methodology":"fee schedule"}]}]},{"description":"LEVEL 1 ER","code_information":[{"code":"3445000010","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":86.4,"maximum":259.2,"gross_charge":270,"discounted_cash":156.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":256.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":259.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":197.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":224.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":197.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":129.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":93.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":86.4,"methodology":"fee schedule"}]}]},{"description":"LEVEL 2 ER","code_information":[{"code":"3445000011","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":151.36,"maximum":454.08,"gross_charge":473,"discounted_cash":274.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":449.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":454.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":345.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":392.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":345.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":227.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":164.04,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":151.36,"methodology":"fee schedule"}]}]},{"description":"LEVEL 3 ER","code_information":[{"code":"3445000012","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":273.92,"maximum":821.76,"gross_charge":856,"discounted_cash":496.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":813.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":821.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":624.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":710.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":624.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":410.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":296.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":273.92,"methodology":"fee schedule"}]}]},{"description":"LEVEL 4 ER","code_information":[{"code":"3445000013","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":439.36,"maximum":1318.08,"gross_charge":1373,"discounted_cash":796.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1304.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1318.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1002.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1139.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1002.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":659.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":476.16,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":439.36,"methodology":"fee schedule"}]}]},{"description":"LEVEL 5 ER","code_information":[{"code":"3445000014","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":641.28,"maximum":1923.84,"gross_charge":2004,"discounted_cash":1162.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1903.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1923.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1462.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1663.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1462.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":961.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":694.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":641.28,"methodology":"fee schedule"}]}]},{"description":"CRIT CARE 30-74 MIN ER","code_information":[{"code":"3445000015","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1024.32,"maximum":3072.96,"gross_charge":3201,"discounted_cash":1856.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3040.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3072.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2336.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2656.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2336.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1536.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1110.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1024.32,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP SCALP <2.5 CM ER","code_information":[{"code":"3445000016","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":165.76,"maximum":497.28,"gross_charge":518,"discounted_cash":300.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":492.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":497.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":378.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":429.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":378.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":248.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":179.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":165.76,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP SCALP 2.6-7.5CM ER","code_information":[{"code":"3445000017","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":176.96,"maximum":530.88,"gross_charge":553,"discounted_cash":320.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":525.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":530.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":403.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":458.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":403.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":265.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":191.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":176.96,"methodology":"fee schedule"}]}]},{"description":"TX FX FIB DIST WO MAN CLSD ER","code_information":[{"code":"3445000019","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":229.76,"maximum":689.28,"gross_charge":718,"discounted_cash":416.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":682.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":689.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":524.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":595.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":524.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":344.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":249.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":229.76,"methodology":"fee schedule"}]}]},{"description":"ARTHEOCENT ASP/INJ JT MAJ ER","code_information":[{"code":"3445000020","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":262.4,"maximum":787.2,"gross_charge":820,"discounted_cash":475.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":779,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":787.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":598.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":680.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":598.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":393.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":284.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":262.4,"methodology":"fee schedule"}]}]},{"description":"AVULSION NAIL PLATE SINGLE ER","code_information":[{"code":"3445000021","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":169.28,"maximum":507.84,"gross_charge":529,"discounted_cash":306.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":502.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":507.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":386.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":386.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":253.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":183.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":169.28,"methodology":"fee schedule"}]}]},{"description":"CNTRL NOSEBLEED POST INIT ER","code_information":[{"code":"3445000022","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":99.84,"maximum":299.52,"gross_charge":312,"discounted_cash":180.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":296.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":299.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":227.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":258.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":227.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":149.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":108.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":99.84,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT FACE 2.6-5.0CM ER","code_information":[{"code":"3445000025","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":311.68,"maximum":935.04,"gross_charge":974,"discounted_cash":564.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":925.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":935.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":711.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":808.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":711.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":467.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":337.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":311.68,"methodology":"fee schedule"}]}]},{"description":"CPR ER","code_information":[{"code":"3445000027","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":627.84,"maximum":1883.52,"gross_charge":1962,"discounted_cash":1137.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1863.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1883.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1432.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1628.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1432.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":941.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":680.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":627.84,"methodology":"fee schedule"}]}]},{"description":"TX DISL SHLDR W MAN CLSD ER","code_information":[{"code":"3445000033","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":225.28,"maximum":675.84,"gross_charge":704,"discounted_cash":408.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":668.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":675.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":513.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":584.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":513.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":337.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":244.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":225.28,"methodology":"fee schedule"}]}]},{"description":"CONTROL NOSEBLEED ANT SMPLE ER","code_information":[{"code":"3445000037","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":101.76,"maximum":305.28,"gross_charge":318,"discounted_cash":184.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":302.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":305.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":232.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":263.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":232.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":110.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":101.76,"methodology":"fee schedule"}]}]},{"description":"DRESS/DEB BURN <5% TOTAL SM ER","code_information":[{"code":"3445000038","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":167.36,"maximum":502.08,"gross_charge":523,"discounted_cash":303.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":496.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":502.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":381.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":434.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":381.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":251.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":181.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":167.36,"methodology":"fee schedule"}]}]},{"description":"RPR LAC CPLX SCALP 2.6-7.5C ER","code_information":[{"code":"3445000042","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":488.96,"maximum":1466.88,"gross_charge":1528,"discounted_cash":886.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1451.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1466.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1115.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1268.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1115.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":733.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":529.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":488.96,"methodology":"fee schedule"}]}]},{"description":"BLADDER INSTILL AGENT ER","code_information":[{"code":"3445000043","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":234.88,"maximum":704.64,"gross_charge":734,"discounted_cash":425.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":697.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":704.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":535.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":609.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":535.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":352.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":254.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":234.88,"methodology":"fee schedule"}]}]},{"description":"TX DISL (I-P) HAND WO ANES ER","code_information":[{"code":"3445000046","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":245.76,"maximum":737.28,"gross_charge":768,"discounted_cash":445.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":729.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":737.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":560.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":637.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":560.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":368.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":266.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":245.76,"methodology":"fee schedule"}]}]},{"description":"INJ SINGLE TENDON/LIGAMENT ER","code_information":[{"code":"3445000049","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":283.2,"maximum":849.6,"gross_charge":885,"discounted_cash":513.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":840.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":849.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":646.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":734.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":646.05,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":424.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":306.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":283.2,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP SCALP 12.6-20.0 ER","code_information":[{"code":"3445000050","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":328,"maximum":984,"gross_charge":1025,"discounted_cash":594.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":973.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":984,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":748.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":850.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":748.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":492,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":355.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":328,"methodology":"fee schedule"}]}]},{"description":"TX DISL SHLDR W MAN/ANES CL ER","code_information":[{"code":"3445000054","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1442.88,"maximum":4328.64,"gross_charge":4509,"discounted_cash":2615.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4283.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4328.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3291.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3742.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3291.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2164.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1563.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1442.88,"methodology":"fee schedule"}]}]},{"description":"TX DISL HIP POST W ANES ER","code_information":[{"code":"3445000055","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1226.24,"maximum":3678.72,"gross_charge":3832,"discounted_cash":2222.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3640.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3678.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2797.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3180.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2797.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1839.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1328.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1226.24,"methodology":"fee schedule"}]}]},{"description":"DRESS/DEBR BURN >10% TTL LG ER","code_information":[{"code":"3445000056","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":309.12,"maximum":927.36,"gross_charge":966,"discounted_cash":560.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":917.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":927.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":705.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":801.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":705.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":463.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":335.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":309.12,"methodology":"fee schedule"}]}]},{"description":"REMOVE FB FOOT COMPLEX ER","code_information":[{"code":"3445000067","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1224.96,"maximum":3674.88,"gross_charge":3828,"discounted_cash":2220.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3636.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3674.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2794.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3177.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2794.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1837.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1327.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1224.96,"methodology":"fee schedule"}]}]},{"description":"REMOVE FB FOOT SUBQ ER","code_information":[{"code":"3445000068","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":612.8,"maximum":1838.4,"gross_charge":1915,"discounted_cash":1110.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1819.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1838.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1397.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1589.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1397.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":919.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":664.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":612.8,"methodology":"fee schedule"}]}]},{"description":"RPR LAC MOUTH/TONGUE <2.5CM ER","code_information":[{"code":"3445000076","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":117.44,"maximum":352.32,"gross_charge":367,"discounted_cash":212.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":348.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":352.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":267.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":304.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":267.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":127.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":117.44,"methodology":"fee schedule"}]}]},{"description":"INCISION/REM FB CMPLX ER","code_information":[{"code":"3445000078","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1248.96,"maximum":3746.88,"gross_charge":3903,"discounted_cash":2263.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3707.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3746.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2849.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3239.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2849.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1873.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1353.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1248.96,"methodology":"fee schedule"}]}]},{"description":"CLOSE LAC MOUTH <2.5CM OR L ER","code_information":[{"code":"3445000079","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":200,"maximum":600,"gross_charge":625,"discounted_cash":362.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":593.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":600,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":456.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":518.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":456.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":300,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":216.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":200,"methodology":"fee schedule"}]}]},{"description":"REM/BIV CAST BODY ER","code_information":[{"code":"3445000081","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":254.08,"maximum":762.24,"gross_charge":794,"discounted_cash":460.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":754.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":762.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":579.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":659.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":579.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":381.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":275.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":254.08,"methodology":"fee schedule"}]}]},{"description":"TX FX RADIUS/ULNA W MAN CLS ER","code_information":[{"code":"3445000082","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1201.92,"maximum":3605.76,"gross_charge":3756,"discounted_cash":2178.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3568.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3605.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2741.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3117.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2741.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1802.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1302.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1201.92,"methodology":"fee schedule"}]}]},{"description":"RPR LAC CPLX SCALP ADD 5.0C ER","code_information":[{"code":"3445000086","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":182.4,"maximum":547.2,"gross_charge":570,"discounted_cash":330.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":541.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":547.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":416.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":473.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":416.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":273.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":197.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":182.4,"methodology":"fee schedule"}]}]},{"description":"APPL SPLINT ARM SHORT STAT ER","code_information":[{"code":"3445000087","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":119.04,"maximum":357.12,"gross_charge":372,"discounted_cash":215.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":353.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":357.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":308.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":178.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":129.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"}]}]},{"description":"IRRIG/LAVG/INSTL BLADDER ER","code_information":[{"code":"3445000089","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":217.28,"maximum":651.84,"gross_charge":679,"discounted_cash":393.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":645.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":651.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":495.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":563.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":495.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":325.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":235.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":217.28,"methodology":"fee schedule"}]}]},{"description":"STRAPPING SHOULDR (VELPEAU) ER","code_information":[{"code":"3445000091","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":112.96,"maximum":338.88,"gross_charge":353,"discounted_cash":204.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":335.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":338.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":257.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":292.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":257.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":169.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":122.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":112.96,"methodology":"fee schedule"}]}]},{"description":"REMOVAL CERUMEN IMPACTED ER","code_information":[{"code":"3445000092","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":80.96,"maximum":242.88,"gross_charge":253,"discounted_cash":146.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":240.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":242.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":184.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":209.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":184.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":121.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":87.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":80.96,"methodology":"fee schedule"}]}]},{"description":"CARDIOVERSION EXTERNA ER","code_information":[{"code":"3445000095","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":457.6,"maximum":1372.8,"gross_charge":1430,"discounted_cash":829.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1358.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1372.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1043.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1186.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1043.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":686.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":495.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":457.6,"methodology":"fee schedule"}]}]},{"description":"INJ NEUROLYTIC CERV/THOR ER","code_information":[{"code":"3445000097","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":845.76,"maximum":2537.28,"gross_charge":2643,"discounted_cash":1532.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2510.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2537.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1929.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2193.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1929.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1268.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":916.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":845.76,"methodology":"fee schedule"}]}]},{"description":"THOMBOLYS CORON IV ER","code_information":[{"code":"3445000098","type":"CDM"},{"code":"0481","type":"RC"}],"standard_charges":[{"minimum":358.4,"maximum":1075.2,"gross_charge":1120,"discounted_cash":649.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1064,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1075.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":817.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":929.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":817.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":537.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":388.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":358.4,"methodology":"fee schedule"}]}]},{"description":"REM FB CANAL AUD WO ER","code_information":[{"code":"3445000101","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":139.84,"maximum":419.52,"gross_charge":437,"discounted_cash":253.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":415.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":419.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":319.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":362.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":319.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":209.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":151.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":139.84,"methodology":"fee schedule"}]}]},{"description":"CNTRL NOSEBLEED ANT CPLX ER","code_information":[{"code":"3445000104","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":117.12,"maximum":351.36,"gross_charge":366,"discounted_cash":212.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":347.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":351.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":267.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":303.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":267.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":175.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":126.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":117.12,"methodology":"fee schedule"}]}]},{"description":"STRAPPING ELBOW/WRIST ER","code_information":[{"code":"3445000106","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":34.24,"maximum":102.72,"gross_charge":107,"discounted_cash":62.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":101.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":102.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":78.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":88.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":78.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":37.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":34.24,"methodology":"fee schedule"}]}]},{"description":"I&D HEMATOMA SEROMA ER","code_information":[{"code":"3445000107","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1349.12,"maximum":4047.36,"gross_charge":4216,"discounted_cash":2445.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4005.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4047.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3077.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3499.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3077.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2023.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1462.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1349.12,"methodology":"fee schedule"}]}]},{"description":"I&D CYST PILONIDAL SMP ER","code_information":[{"code":"3445000115","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":573.76,"maximum":1721.28,"gross_charge":1793,"discounted_cash":1039.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1703.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1721.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1308.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1488.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1308.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":860.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":621.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":573.76,"methodology":"fee schedule"}]}]},{"description":"ADD WALKER TO CAST ER","code_information":[{"code":"3445000123","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":145.6,"maximum":436.8,"gross_charge":455,"discounted_cash":263.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":432.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":436.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":332.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":377.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":332.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":157.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":145.6,"methodology":"fee schedule"}]}]},{"description":"CNTRL NOSEBLEED POST SUBSEQ ER","code_information":[{"code":"3445000125","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":168.96,"maximum":506.88,"gross_charge":528,"discounted_cash":306.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":501.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":506.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":385.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":438.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":385.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":253.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":183.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":168.96,"methodology":"fee schedule"}]}]},{"description":"DRAIN ABS/CYST MOUTH SMP ER","code_information":[{"code":"3445000126","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":640.64,"maximum":1921.92,"gross_charge":2002,"discounted_cash":1161.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1901.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1921.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1461.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1661.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1461.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":960.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":694.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":640.64,"methodology":"fee schedule"}]}]},{"description":"INTUBATION ENDOTRACHEAL ER","code_information":[{"code":"3445000132","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":168.64,"maximum":505.92,"gross_charge":527,"discounted_cash":305.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":500.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":505.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":384.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":437.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":384.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":252.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":182.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":168.64,"methodology":"fee schedule"}]}]},{"description":"TEMP EXTERNAL PACNG ER","code_information":[{"code":"3445000138","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":15.36,"maximum":46.08,"gross_charge":48,"discounted_cash":27.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":45.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":46.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":15.36,"methodology":"fee schedule"}]}]},{"description":"TX FX NASAL SIMPLE OPEN ER","code_information":[{"code":"3445000145","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1879.68,"maximum":5639.04,"gross_charge":5874,"discounted_cash":3406.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5580.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5639.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4288.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4875.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4288.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2819.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2037.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1879.68,"methodology":"fee schedule"}]}]},{"description":"NASAL/ORO INSERTION W STENT ER","code_information":[{"code":"3445000147","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":342.4,"maximum":1027.2,"gross_charge":1070,"discounted_cash":620.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1016.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1027.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":781.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":888.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":781.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":513.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":371.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":342.4,"methodology":"fee schedule"}]}]},{"description":"INJ CYSTOGRAM ER","code_information":[{"code":"3445000149","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":147.52,"maximum":442.56,"gross_charge":461,"discounted_cash":267.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":437.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":442.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":336.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":382.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":336.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":221.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":159.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":147.52,"methodology":"fee schedule"}]}]},{"description":"INS CATH CV NON-TUNL >5YRS ER","code_information":[{"code":"3445000152","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":912,"maximum":2736,"gross_charge":2850,"discounted_cash":1653,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2707.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2736,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2080.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2365.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2080.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1368,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":988.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":912,"methodology":"fee schedule"}]}]},{"description":"EVAC HEMATOMA SUBUNGAL ER","code_information":[{"code":"3445000155","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":105.28,"maximum":315.84,"gross_charge":329,"discounted_cash":190.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":312.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":315.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":157.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":114.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":105.28,"methodology":"fee schedule"}]}]},{"description":"CNTRL HEMORR OROPHARY SMP ER","code_information":[{"code":"3445000156","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":514.56,"maximum":1543.68,"gross_charge":1608,"discounted_cash":932.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1527.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1543.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1173.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1334.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1173.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":771.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":557.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":514.56,"methodology":"fee schedule"}]}]},{"description":"I&D EAR ABSC/HEMA SIMPLE ER","code_information":[{"code":"3445000157","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":762.88,"maximum":2288.64,"gross_charge":2384,"discounted_cash":1382.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2264.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2288.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1740.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1978.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1740.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1144.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":826.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":762.88,"methodology":"fee schedule"}]}]},{"description":"CRITICAL CARE ADDL 30 MIN ER","code_information":[{"code":"3445000158","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":151.04,"maximum":453.12,"gross_charge":472,"discounted_cash":273.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":448.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":453.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":344.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":391.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":344.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":226.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":163.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":151.04,"methodology":"fee schedule"}]}]},{"description":"APPL SPLINT LEG SHORT ER","code_information":[{"code":"3445000160","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":144.32,"maximum":432.96,"gross_charge":451,"discounted_cash":261.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":428.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":432.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":329.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":374.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":329.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":216.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":156.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":144.32,"methodology":"fee schedule"}]}]},{"description":"I&D ABSC PERIANAL SUPERFIC ER","code_information":[{"code":"3445000164","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":793.6,"maximum":2380.8,"gross_charge":2480,"discounted_cash":1438.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2356,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2380.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1810.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2058.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1810.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1190.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":860.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":793.6,"methodology":"fee schedule"}]}]},{"description":"ASP CATH NASOTRACHEAL ER","code_information":[{"code":"3445000170","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":176.32,"maximum":528.96,"gross_charge":551,"discounted_cash":319.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":523.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":528.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":402.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":457.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":402.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":264.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":191.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":176.32,"methodology":"fee schedule"}]}]},{"description":"APPL SPLINT FINGER DYNAMIC ER","code_information":[{"code":"3445000172","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":60.48,"maximum":181.44,"gross_charge":189,"discounted_cash":109.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":179.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":181.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":137.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":156.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":137.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":90.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":65.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":60.48,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF SCROTUM ER","code_information":[{"code":"3445000173","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1499.52,"maximum":4498.56,"gross_charge":4686,"discounted_cash":2717.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4451.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4498.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3420.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3889.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3420.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2249.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1625.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1499.52,"methodology":"fee schedule"}]}]},{"description":"I&D ABSC/BURSA THIGH/KNEE ER","code_information":[{"code":"3445000174","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":2111.68,"maximum":6335.04,"gross_charge":6599,"discounted_cash":3827.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6269.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6335.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4817.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5477.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4817.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3167.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2288.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2111.68,"methodology":"fee schedule"}]}]},{"description":"I&D ABSCESS COMPLEX ER","code_information":[{"code":"3445000175","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":288.64,"maximum":865.92,"gross_charge":902,"discounted_cash":523.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":856.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":865.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":658.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":748.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":658.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":432.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":312.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":288.64,"methodology":"fee schedule"}]}]},{"description":"ASP BLADDER NEEDLE/INTRCTH ER","code_information":[{"code":"3445000178","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":921.6,"maximum":2764.8,"gross_charge":2880,"discounted_cash":1670.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2736,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2764.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2102.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2390.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2102.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1382.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":998.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":921.6,"methodology":"fee schedule"}]}]},{"description":"INTUBTN GASTRIC TREATMENT ER","code_information":[{"code":"3445000180","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":278.4,"maximum":835.2,"gross_charge":870,"discounted_cash":504.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":826.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":835.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":635.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":722.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":635.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":417.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":301.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":278.4,"methodology":"fee schedule"}]}]},{"description":"LARYNGOSCOPY INDIRECT ER","code_information":[{"code":"3445000184","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":148.8,"maximum":446.4,"gross_charge":465,"discounted_cash":269.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":441.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":446.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":339.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":385.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":339.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":223.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":161.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":148.8,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT SCALP >30.0CM ER","code_information":[{"code":"3445000187","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1569.92,"maximum":4709.76,"gross_charge":4906,"discounted_cash":2845.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4660.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4709.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3581.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4071.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3581.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2354.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1701.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1569.92,"methodology":"fee schedule"}]}]},{"description":"NASOPHARYNGOSCOPY ER","code_information":[{"code":"3445000188","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":181.12,"maximum":543.36,"gross_charge":566,"discounted_cash":328.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":537.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":543.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":413.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":469.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":413.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":271.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":196.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":181.12,"methodology":"fee schedule"}]}]},{"description":"REMOVE FB PHARYNX ER","code_information":[{"code":"3445000189","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":369.6,"maximum":1108.8,"gross_charge":1155,"discounted_cash":669.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1097.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1108.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":843.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":958.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":843.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":554.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":400.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":369.6,"methodology":"fee schedule"}]}]},{"description":"MEATOTOMY EXCEPT INFANT ER","code_information":[{"code":"3445000190","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1471.36,"maximum":4414.08,"gross_charge":4598,"discounted_cash":2666.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4368.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4414.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3356.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3816.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3356.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2207.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1594.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1471.36,"methodology":"fee schedule"}]}]},{"description":"ESOPHAGOSC FLEX TRANSOR DX ER","code_information":[{"code":"3445000193","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":832,"maximum":2496,"gross_charge":2600,"discounted_cash":1508,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2470,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2496,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1898,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2158,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1898,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1248,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":901.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":832,"methodology":"fee schedule"}]}]},{"description":"REMOVE FB ARM/ELBOW SUBQ ER","code_information":[{"code":"3445000198","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1440.32,"maximum":4320.96,"gross_charge":4501,"discounted_cash":2610.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4275.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4320.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3285.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3735.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3285.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2160.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1560.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1440.32,"methodology":"fee schedule"}]}]},{"description":"REM FB CONJUCT EMBED ER","code_information":[{"code":"3445000203","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":419.84,"maximum":1259.52,"gross_charge":1312,"discounted_cash":760.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1246.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1259.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":957.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1088.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":957.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":629.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":455.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":419.84,"methodology":"fee schedule"}]}]},{"description":"REM FB CORNL WO SLIT ER","code_information":[{"code":"3445000204","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":421.44,"maximum":1264.32,"gross_charge":1317,"discounted_cash":763.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1251.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1264.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":961.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1093.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":961.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":632.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":456.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":421.44,"methodology":"fee schedule"}]}]},{"description":"REM IMPACTN FECL/FB W ANES ER","code_information":[{"code":"3445000208","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1046.72,"maximum":3140.16,"gross_charge":3271,"discounted_cash":1897.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3107.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3140.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2387.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2714.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2387.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1570.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1134.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1046.72,"methodology":"fee schedule"}]}]},{"description":"DRAIN ABSC FINGER SIMPLE ER","code_information":[{"code":"3445000209","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":180.8,"maximum":542.4,"gross_charge":565,"discounted_cash":327.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":536.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":542.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":412.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":468.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":412.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":271.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":195.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":180.8,"methodology":"fee schedule"}]}]},{"description":"INC HEMORRHOID EXTERNAL ER","code_information":[{"code":"3445000210","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":256.64,"maximum":769.92,"gross_charge":802,"discounted_cash":465.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":761.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":769.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":585.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":665.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":585.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":384.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":278.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":256.64,"methodology":"fee schedule"}]}]},{"description":"I&D ABS GLAND BARTHOLINS ER","code_information":[{"code":"3445000211","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":156.16,"maximum":468.48,"gross_charge":488,"discounted_cash":283.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":463.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":468.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":356.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":405.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":356.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":234.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":169.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":156.16,"methodology":"fee schedule"}]}]},{"description":"INS DEVICE CV W PRT > 5 YRS ER","code_information":[{"code":"3445000213","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":2494.08,"maximum":7482.24,"gross_charge":7794,"discounted_cash":4520.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7404.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7482.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5689.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6469.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5689.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3741.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2702.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2494.08,"methodology":"fee schedule"}]}]},{"description":"REM TUNNELED CVC WO PMP ER","code_information":[{"code":"3445000217","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":720.96,"maximum":2162.88,"gross_charge":2253,"discounted_cash":1306.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2140.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2162.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1644.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1869.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1644.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1081.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":781.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":720.96,"methodology":"fee schedule"}]}]},{"description":"PLACE NDL INFS INTRAOSSEO ER","code_information":[{"code":"3445000220","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":388.8,"maximum":1166.4,"gross_charge":1215,"discounted_cash":704.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1154.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1166.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":886.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1008.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":886.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":583.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":421.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":388.8,"methodology":"fee schedule"}]}]},{"description":"COLOPERINEORRHAPHY NON-OB ER","code_information":[{"code":"3445000223","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1873.92,"maximum":5621.76,"gross_charge":5856,"discounted_cash":3396.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5563.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5621.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4274.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4860.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4274.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2810.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2030.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1873.92,"methodology":"fee schedule"}]}]},{"description":"LIG ARTERY EXTREM MAJ ER","code_information":[{"code":"3445000226","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":2398.72,"maximum":7196.16,"gross_charge":7496,"discounted_cash":4347.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7121.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7196.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5472.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6221.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5472.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3598.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2599.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2398.72,"methodology":"fee schedule"}]}]},{"description":"APPLICATION SPLINT ARM LONG ER","code_information":[{"code":"3445000240","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":153.28,"maximum":459.84,"gross_charge":479,"discounted_cash":277.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":455.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":459.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":349.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":397.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":349.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":229.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":166.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":153.28,"methodology":"fee schedule"}]}]},{"description":"SURG TX ABOTION INCMPL ER","code_information":[{"code":"3445000243","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":2051.84,"maximum":6155.52,"gross_charge":6412,"discounted_cash":3718.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6091.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6155.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4680.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5321.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4680.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3077.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2223.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2051.84,"methodology":"fee schedule"}]}]},{"description":"REM FB EYELID EMBEDDED ER","code_information":[{"code":"3445000251","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":340.48,"maximum":1021.44,"gross_charge":1064,"discounted_cash":617.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1010.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1021.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":776.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":883.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":776.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":510.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":369,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":340.48,"methodology":"fee schedule"}]}]},{"description":"FME & EMTALA SCREENING","code_information":[{"code":"3445000254","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":208,"maximum":624,"gross_charge":650,"discounted_cash":377,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":617.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":624,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":474.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":539.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":474.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":312,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":225.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":208,"methodology":"fee schedule"}]}]},{"description":"TX FX BONE NASAL WO STABL ER","code_information":[{"code":"3445000277","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1216.64,"maximum":3649.92,"gross_charge":3802,"discounted_cash":2205.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3611.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3649.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2775.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3155.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2775.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1824.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1318.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1216.64,"methodology":"fee schedule"}]}]},{"description":"RPR LAC CPLX FOREHD ADD 5CM ER","code_information":[{"code":"3445000280","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":246.08,"maximum":738.24,"gross_charge":769,"discounted_cash":446.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":730.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":738.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":561.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":638.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":561.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":369.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":266.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":246.08,"methodology":"fee schedule"}]}]},{"description":"DEST LESN PENIS CRYO ER","code_information":[{"code":"3445000298","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":164.16,"maximum":492.48,"gross_charge":513,"discounted_cash":297.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":487.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":492.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":374.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":425.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":374.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":246.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":177.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":164.16,"methodology":"fee schedule"}]}]},{"description":"REM FB MUSC/TENDON CPLX ER","code_information":[{"code":"3445000300","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1987.52,"maximum":5962.56,"gross_charge":6211,"discounted_cash":3602.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5900.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5962.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4534.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5155.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4534.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2981.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2153.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1987.52,"methodology":"fee schedule"}]}]},{"description":"I&D ABSC VULNA/PERINEAL ER","code_information":[{"code":"3445000304","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":260.48,"maximum":781.44,"gross_charge":814,"discounted_cash":472.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":773.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":781.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":594.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":675.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":594.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":390.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":282.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":260.48,"methodology":"fee schedule"}]}]},{"description":"TX FX CARPAL CLSD WO MAN ER","code_information":[{"code":"3445000306","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":451.2,"maximum":1353.6,"gross_charge":1410,"discounted_cash":817.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1339.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1353.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1029.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1170.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1029.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":676.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":488.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":451.2,"methodology":"fee schedule"}]}]},{"description":"RPR LAC MOUTH/TONGUE >2.6CM ER","code_information":[{"code":"3445000308","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":405.44,"maximum":1216.32,"gross_charge":1267,"discounted_cash":734.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1203.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1216.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":924.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1051.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":924.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":608.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":439.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":405.44,"methodology":"fee schedule"}]}]},{"description":"ENDO NASAL W CONTROL BLDNG ER","code_information":[{"code":"3445000316","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1062.4,"maximum":3187.2,"gross_charge":3320,"discounted_cash":1925.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3154,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3187.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2423.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2755.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2423.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1593.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1151.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1062.4,"methodology":"fee schedule"}]}]},{"description":"DELIVERY VAGINAL ONLY ER","code_information":[{"code":"3445000350","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":1899.84,"maximum":5699.52,"gross_charge":5937,"discounted_cash":3443.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5640.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5699.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4334.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4927.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4334.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2849.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2058.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1899.84,"methodology":"fee schedule"}]}]},{"description":"CEREBRAL THROMBOLYSIS ER","code_information":[{"code":"3445000415","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":350.72,"maximum":1052.16,"gross_charge":1096,"discounted_cash":635.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1041.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1052.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":800.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":909.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":800.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":526.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":380.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":350.72,"methodology":"fee schedule"}]}]},{"description":"I&D ABSC ISCHIO/PERIRECTAL ER","code_information":[{"code":"3445001250","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":766.72,"maximum":2300.16,"gross_charge":2396,"discounted_cash":1389.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2276.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2300.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1749.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1988.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1749.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1150.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":830.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":766.72,"methodology":"fee schedule"}]}]},{"description":"TRAUMA ACT V FULL WO PRE NOT","code_information":[{"code":"3445001251","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":332.48,"maximum":997.44,"gross_charge":1039,"discounted_cash":602.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":987.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":997.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":758.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":862.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":758.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":498.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":360.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":332.48,"methodology":"fee schedule"}]}]},{"description":"TRAUMA ACT V PART WO PRE NOT","code_information":[{"code":"3445001252","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":384,"maximum":1152,"gross_charge":1200,"discounted_cash":696,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1140,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1152,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":876,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":996,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":876,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":576,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":416.16,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":384,"methodology":"fee schedule"}]}]},{"description":"TRAUMA EVAL LVL IV WO PRE NOT","code_information":[{"code":"3445001253","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":192,"maximum":576,"gross_charge":600,"discounted_cash":348,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":570,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":576,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":438,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":498,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":438,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":288,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":208.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":192,"methodology":"fee schedule"}]}]},{"description":"CATH BLADDER SIMPLE ER","code_information":[{"code":"3445008055","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":99.52,"maximum":298.56,"gross_charge":311,"discounted_cash":180.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":295.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":298.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":227.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":258.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":227.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":149.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":107.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":99.52,"methodology":"fee schedule"}]}]},{"description":"MEASURE POST-VOID URI US ER","code_information":[{"code":"3445008060","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":57.6,"maximum":172.8,"gross_charge":180,"discounted_cash":104.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":171,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":172.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":131.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":149.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":131.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":62.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":57.6,"methodology":"fee schedule"}]}]},{"description":"MDI/NEBULIZER SMALL VOL ER","code_information":[{"code":"3445008065","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":39.68,"maximum":119.04,"gross_charge":124,"discounted_cash":71.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":117.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":102.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":43.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":39.68,"methodology":"fee schedule"}]}]},{"description":"REMOVE CERUMEN IMPACTED UNI ER","code_information":[{"code":"3445010020","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":48,"maximum":144,"gross_charge":150,"discounted_cash":87,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":142.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":52.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":48,"methodology":"fee schedule"}]}]},{"description":"BLOOD DRAW ONLY FROM PORT ER","code_information":[{"code":"3445010101","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":97.92,"maximum":293.76,"gross_charge":306,"discounted_cash":177.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":290.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":293.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":223.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":253.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":223.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":106.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":97.92,"methodology":"fee schedule"}]}]},{"description":"INJ ANES NRV TRIGEMINAL ER","code_information":[{"code":"3445010103","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":184.64,"maximum":553.92,"gross_charge":577,"discounted_cash":334.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":548.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":553.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":421.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":478.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":421.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":276.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":200.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":184.64,"methodology":"fee schedule"}]}]},{"description":"TX DISL KNEE WO ANES CLSD ER","code_information":[{"code":"3445010105","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":191.68,"maximum":575.04,"gross_charge":599,"discounted_cash":347.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":569.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":575.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":437.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":497.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":437.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":287.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":207.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":191.68,"methodology":"fee schedule"}]}]},{"description":"IV HYD 1ST HR (31-90M) ER","code_information":[{"code":"3445010200","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":248.64,"maximum":745.92,"gross_charge":777,"discounted_cash":450.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":738.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":745.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":567.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":644.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":567.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":372.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":269.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":248.64,"methodology":"fee schedule"}]}]},{"description":"IV HYD EA ADD HR (91M+) ER","code_information":[{"code":"3445010205","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":47.68,"maximum":143.04,"gross_charge":149,"discounted_cash":86.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":141.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":143.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":123.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":51.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.68,"methodology":"fee schedule"}]}]},{"description":"IV INF SEQ EA ADDL HR ER","code_information":[{"code":"3445010220","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":75.2,"maximum":225.6,"gross_charge":235,"discounted_cash":136.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":223.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":225.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":171.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":195.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":171.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":112.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":81.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":75.2,"methodology":"fee schedule"}]}]},{"description":"IV INF CONCURR PER DAY ER","code_information":[{"code":"3445010225","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":144,"maximum":432,"gross_charge":450,"discounted_cash":261,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":427.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":432,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":328.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":373.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":328.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":216,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":156.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"}]}]},{"description":"INJ SUBQ/IM ER","code_information":[{"code":"3445010230","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":71.04,"maximum":213.12,"gross_charge":222,"discounted_cash":128.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":210.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":213.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":162.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":184.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":162.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":106.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":76.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"}]}]},{"description":"IV PUSH EA ADD DIFF RX ER","code_information":[{"code":"3445010240","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":47.36,"maximum":142.08,"gross_charge":148,"discounted_cash":85.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":140.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":51.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.36,"methodology":"fee schedule"}]}]},{"description":"IV PUSH EA ADD SAME RX ER","code_information":[{"code":"3445010245","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":35.84,"maximum":107.52,"gross_charge":112,"discounted_cash":64.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":106.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":107.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":81.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":92.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":81.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":53.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":38.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":35.84,"methodology":"fee schedule"}]}]},{"description":"EXC LES B TRNK AR 2.1-3. ER","code_information":[{"code":"3445010250","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":584,"maximum":1752,"gross_charge":1825,"discounted_cash":1058.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1733.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1752,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1332.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1514.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1332.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":876,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":632.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":584,"methodology":"fee schedule"}]}]},{"description":"ARTHROCENT ASP/INJ JT SMALL ER","code_information":[{"code":"3445010260","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":280.96,"maximum":842.88,"gross_charge":878,"discounted_cash":509.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":834.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":842.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":640.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":728.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":640.94,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":421.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":304.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":280.96,"methodology":"fee schedule"}]}]},{"description":"TX FX FEM PROX CLOSED ER","code_information":[{"code":"3445010265","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":242.88,"maximum":728.64,"gross_charge":759,"discounted_cash":440.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":721.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":728.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":554.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":629.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":554.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":364.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":263.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":242.88,"methodology":"fee schedule"}]}]},{"description":"APPLICATION CAST LEG LONG ER","code_information":[{"code":"3445010270","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":254.4,"maximum":763.2,"gross_charge":795,"discounted_cash":461.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":755.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":763.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":580.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":659.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":580.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":381.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":275.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":254.4,"methodology":"fee schedule"}]}]},{"description":"DEBR/REM DEV TISSUE <20 ER","code_information":[{"code":"3445010275","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":213.12,"maximum":639.36,"gross_charge":666,"discounted_cash":386.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":632.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":639.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":486.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":552.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":486.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":319.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":230.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":213.12,"methodology":"fee schedule"}]}]},{"description":"PROLONG SERV B/A PT CARE ER","code_information":[{"code":"3445010280","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":44.8,"maximum":134.4,"gross_charge":140,"discounted_cash":81.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":133,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":134.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":102.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":116.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":102.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":48.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":44.8,"methodology":"fee schedule"}]}]},{"description":"RPR LAC MOUTH/TNG PST ER","code_information":[{"code":"3445010290","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":181.44,"maximum":544.32,"gross_charge":567,"discounted_cash":328.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":538.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":544.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":413.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":470.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":413.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":272.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":196.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":181.44,"methodology":"fee schedule"}]}]},{"description":"REM FB CORNEAL W SLIT LAMP ER","code_information":[{"code":"3445010305","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":140.8,"maximum":422.4,"gross_charge":440,"discounted_cash":255.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":418,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":422.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":321.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":365.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":321.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":152.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":140.8,"methodology":"fee schedule"}]}]},{"description":"PUNCTURE ARTERIAL ER","code_information":[{"code":"3445010866","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":89.6,"maximum":268.8,"gross_charge":280,"discounted_cash":162.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":266,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":268.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":204.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":232.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":204.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":134.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":97.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":89.6,"methodology":"fee schedule"}]}]},{"description":"EMTALA LWBS","code_information":[{"code":"3445100100","type":"CDM"},{"code":"0451","type":"RC"}],"standard_charges":[{"minimum":0.01,"maximum":0.01,"gross_charge":0.01,"discounted_cash":0.01,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"}]}]},{"description":"MVV/MBC LUNG FUNCTN TEST","code_information":[{"code":"3446000001","type":"CDM"},{"code":"0460","type":"RC"}],"standard_charges":[{"minimum":46.4,"maximum":139.2,"gross_charge":145,"discounted_cash":84.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":137.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":139.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":105.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":120.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":105.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":69.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":50.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":46.4,"methodology":"fee schedule"}]}]},{"description":"SPIROMETRY VT CAPACITY TEST","code_information":[{"code":"3446000002","type":"CDM"},{"code":"0460","type":"RC"}],"standard_charges":[{"minimum":62.08,"maximum":186.24,"gross_charge":194,"discounted_cash":112.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":184.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":186.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":141.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":161.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":141.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":67.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":62.08,"methodology":"fee schedule"}]}]},{"description":"P & P BRONCHODILATOR/PFT","code_information":[{"code":"3446000003","type":"CDM"},{"code":"0460","type":"RC"}],"standard_charges":[{"minimum":112.32,"maximum":336.96,"gross_charge":351,"discounted_cash":203.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":333.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":336.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":256.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":291.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":256.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":168.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":121.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":112.32,"methodology":"fee schedule"}]}]},{"description":"RT-PULSE OXIMETRY SINGLE DET","code_information":[{"code":"3446000004","type":"CDM"},{"code":"0460","type":"RC"}],"standard_charges":[{"minimum":26.56,"maximum":79.68,"gross_charge":83,"discounted_cash":48.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":78.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":60.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":60.59,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":28.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":26.56,"methodology":"fee schedule"}]}]},{"description":"RT-PULSE OX-MULITPLE DETERMI","code_information":[{"code":"3446000006","type":"CDM"},{"code":"0460","type":"RC"}],"standard_charges":[{"minimum":52.16,"maximum":156.48,"gross_charge":163,"discounted_cash":94.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":154.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":156.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":118.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":135.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":118.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":78.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":56.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":52.16,"methodology":"fee schedule"}]}]},{"description":"NOC PULSE OX MONITORING","code_information":[{"code":"3446000007","type":"CDM"},{"code":"0460","type":"RC"}],"standard_charges":[{"minimum":89.28,"maximum":267.84,"gross_charge":279,"discounted_cash":161.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":265.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":267.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":203.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":231.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":203.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":133.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":96.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":89.28,"methodology":"fee schedule"}]}]},{"description":"UNLISTED PULM SERV/PROC","code_information":[{"code":"3446000065","type":"CDM"},{"code":"0460","type":"RC"}],"standard_charges":[{"minimum":84.48,"maximum":253.44,"gross_charge":264,"discounted_cash":153.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":250.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":253.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":192.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":219.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":192.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":126.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":91.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":84.48,"methodology":"fee schedule"}]}]},{"description":"PULMONARY STRESS TESTING","code_information":[{"code":"3446000100","type":"CDM"},{"code":"0460","type":"RC"}],"standard_charges":[{"minimum":126.72,"maximum":380.16,"gross_charge":396,"discounted_cash":229.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":376.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":380.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":289.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":328.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":289.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":190.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":137.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":126.72,"methodology":"fee schedule"}]}]},{"description":"CARDIOVERSION","code_information":[{"code":"3448000005","type":"CDM"},{"code":"0480","type":"RC"}],"standard_charges":[{"minimum":363.84,"maximum":1091.52,"gross_charge":1137,"discounted_cash":659.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1080.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1091.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":830.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":943.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":830.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":545.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":394.32,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":363.84,"methodology":"fee schedule"}]}]},{"description":"CARDIAC STRESS TEST TRACING","code_information":[{"code":"3448200001","type":"CDM"},{"code":"0482","type":"RC"}],"standard_charges":[{"minimum":188.48,"maximum":565.44,"gross_charge":589,"discounted_cash":341.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":559.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":565.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":429.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":488.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":429.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":282.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":204.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":188.48,"methodology":"fee schedule"}]}]},{"description":"OFF/OP NEW LVL 2 CLIN FAC","code_information":[{"code":"3451010105","type":"CDM"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":16.32,"maximum":48.96,"gross_charge":51,"discounted_cash":29.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":48.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":48.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":37.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":42.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":37.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":24.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":17.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.32,"methodology":"fee schedule"}]}]},{"description":"OFF/OP NEW LVL 3 CLIN FAC","code_information":[{"code":"3451010110","type":"CDM"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":25.28,"maximum":75.84,"gross_charge":79,"discounted_cash":45.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":75.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":57.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":65.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":57.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":37.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":27.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":25.28,"methodology":"fee schedule"}]}]},{"description":"OFF/OP NEW LVL 4 CLIN FAC","code_information":[{"code":"3451010115","type":"CDM"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":37.76,"maximum":113.28,"gross_charge":118,"discounted_cash":68.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":112.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":113.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":86.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":86.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":40.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":37.76,"methodology":"fee schedule"}]}]},{"description":"OFF/OP NEW LVL 5 CLIN FAC","code_information":[{"code":"3451010120","type":"CDM"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":49.92,"maximum":149.76,"gross_charge":156,"discounted_cash":90.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":148.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":149.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":113.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":129.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":113.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":74.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":54.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":49.92,"methodology":"fee schedule"}]}]},{"description":"OFF/OP EST LVL 1 CLIN FAC","code_information":[{"code":"3451010125","type":"CDM"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":5.12,"maximum":15.36,"gross_charge":16,"discounted_cash":9.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":15.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":15.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":11.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":7.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":5.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.12,"methodology":"fee schedule"}]}]},{"description":"OFF/OP EST LVL 2 CLIN FAC","code_information":[{"code":"3451010130","type":"CDM"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":12.8,"maximum":38.4,"gross_charge":40,"discounted_cash":23.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":12.8,"methodology":"fee schedule"}]}]},{"description":"OFF/OP EST LVL 3 CLIN FAC","code_information":[{"code":"3451010135","type":"CDM"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":20.8,"maximum":62.4,"gross_charge":65,"discounted_cash":37.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":61.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":62.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":47.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":53.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":47.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":31.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":22.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":20.8,"methodology":"fee schedule"}]}]},{"description":"OFF/OP EST LVL 4 CLIN FAC","code_information":[{"code":"3451010140","type":"CDM"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":29.12,"maximum":87.36,"gross_charge":91,"discounted_cash":52.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":86.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":87.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":66.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":75.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":66.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":43.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":31.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":29.12,"methodology":"fee schedule"}]}]},{"description":"OFF/OP EST LVL 5 CLIN FAC","code_information":[{"code":"3451010145","type":"CDM"},{"code":"0510","type":"RC"}],"standard_charges":[{"minimum":40.64,"maximum":121.92,"gross_charge":127,"discounted_cash":73.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":120.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":121.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":92.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":105.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":92.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":60.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":44.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":40.64,"methodology":"fee schedule"}]}]},{"description":"PIN FIX 2.0 MM","code_information":[{"code":"345300","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1070.18,"maximum":1407.36,"gross_charge":1466,"discounted_cash":850.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1392.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1407.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1070.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1216.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1070.18,"methodology":"fee schedule"}]}]},{"description":"PIN FIX 2.0 MM","code_information":[{"code":"345300","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":469.12,"maximum":1407.36,"gross_charge":1466,"discounted_cash":850.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1392.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1407.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1070.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1216.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1070.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":703.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":508.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":469.12,"methodology":"fee schedule"}]}]},{"description":"ALS-EMERGENCY-LEV 1","code_information":[{"code":"3454000001","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":475.2,"maximum":1425.6,"gross_charge":1485,"discounted_cash":861.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1410.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1425.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1084.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1232.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1084.05,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":712.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":515,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":475.2,"methodology":"fee schedule"}]}]},{"description":"ALS-LEVEL 1","code_information":[{"code":"3454000002","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":302.4,"maximum":907.2,"gross_charge":945,"discounted_cash":548.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":897.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":907.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":689.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":784.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":689.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":453.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":327.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":302.4,"methodology":"fee schedule"}]}]},{"description":"ALS-LEVEL 2","code_information":[{"code":"3454000003","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":721.28,"maximum":2163.84,"gross_charge":2254,"discounted_cash":1307.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2141.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2163.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1645.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1870.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1645.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1081.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":781.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":721.28,"methodology":"fee schedule"}]}]},{"description":"AMB RESPONSE & TX NO TRANSF","code_information":[{"code":"3454000004","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":271.68,"maximum":815.04,"gross_charge":849,"discounted_cash":492.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":806.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":815.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":619.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":704.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":619.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":407.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":294.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":271.68,"methodology":"fee schedule"}]}]},{"description":"AMB TRANSFER TO LTC","code_information":[{"code":"3454000005","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":59.84,"maximum":179.52,"gross_charge":187,"discounted_cash":108.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":177.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":179.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":136.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":155.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":136.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":89.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":64.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":59.84,"methodology":"fee schedule"}]}]},{"description":"BASIC LIFE SUPPORT","code_information":[{"code":"3454000007","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":252.16,"maximum":756.48,"gross_charge":788,"discounted_cash":457.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":748.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":756.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":575.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":654.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":575.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":378.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":273.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":252.16,"methodology":"fee schedule"}]}]},{"description":"BLS-EMERGENCY","code_information":[{"code":"3454000008","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":401.28,"maximum":1203.84,"gross_charge":1254,"discounted_cash":727.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1191.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1203.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":915.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1040.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":915.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":601.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":434.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":401.28,"methodology":"fee schedule"}]}]},{"description":"COVERED GROUND MILES","code_information":[{"code":"3454000009","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":0.96,"maximum":2.88,"gross_charge":3,"discounted_cash":1.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.96,"methodology":"fee schedule"}]}]},{"description":"SPECIALTY CARE TRANS","code_information":[{"code":"3454000012","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":927.04,"maximum":2781.12,"gross_charge":2897,"discounted_cash":1680.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2752.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2781.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2114.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2404.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2114.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1390.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1004.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":927.04,"methodology":"fee schedule"}]}]},{"description":"DOA MILEAGE","code_information":[{"code":"3454000013","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":0.64,"maximum":1.92,"gross_charge":2,"discounted_cash":1.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":0.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":0.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.64,"methodology":"fee schedule"}]}]},{"description":"DOA TRANSPORT FUNERAL HOME","code_information":[{"code":"3454000014","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":96,"maximum":288,"gross_charge":300,"discounted_cash":174,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":285,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":288,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":219,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":249,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":219,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":104.04,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":96,"methodology":"fee schedule"}]}]},{"description":"DOA COMPLEX TRANSPORT FUNERAL","code_information":[{"code":"3454000015","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":160,"maximum":480,"gross_charge":500,"discounted_cash":290,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":475,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":480,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":365,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":415,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":365,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":240,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":173.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":160,"methodology":"fee schedule"}]}]},{"description":"AMB INTERCEPT CLIENT BILLING","code_information":[{"code":"3454099998","type":"CDM"},{"code":"0540","type":"RC"}],"standard_charges":[{"minimum":72,"maximum":216,"gross_charge":225,"discounted_cash":130.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":213.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":216,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":164.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":186.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":164.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72,"methodology":"fee schedule"}]}]},{"description":"CONNECTIVE TISSUE DISORDERS","code_information":[{"code":"3461","type":"APR-DRG"}],"standard_charges":[{"minimum":14138,"maximum":14138,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14138,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CONNECTIVE TISSUE DISORDERS","code_information":[{"code":"3462","type":"APR-DRG"}],"standard_charges":[{"minimum":31136,"maximum":31136,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31136,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CONNECTIVE TISSUE DISORDERS","code_information":[{"code":"3463","type":"APR-DRG"}],"standard_charges":[{"minimum":44774,"maximum":44774,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44774,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CEFTRIAXONE SODIUM INJECT CLIN","code_information":[{"code":"3463610140","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":3.84,"maximum":11.52,"gross_charge":12,"discounted_cash":6.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":4.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3.84,"methodology":"fee schedule"}]}]},{"description":"STPLR ECHELON FLEX","code_information":[{"code":"346362","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":600.79,"maximum":790.08,"gross_charge":823,"discounted_cash":477.34,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":781.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":790.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":683.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":600.79,"methodology":"fee schedule"}]}]},{"description":"STPLR ECHELON FLEX","code_information":[{"code":"346362","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":263.36,"maximum":790.08,"gross_charge":823,"discounted_cash":477.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":781.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":790.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":600.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":683.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":600.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":395.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":285.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":263.36,"methodology":"fee schedule"}]}]},{"description":"VITAMIN B12 INJECTION","code_information":[{"code":"3463620000","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":32,"maximum":96,"gross_charge":100,"discounted_cash":58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":34.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":32,"methodology":"fee schedule"}]}]},{"description":"CONNECTIVE TISSUE DISORDERS","code_information":[{"code":"3464","type":"APR-DRG"}],"standard_charges":[{"minimum":102339,"maximum":102339,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":102339,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRAUMA ACTIVATION W CRIT CARE","code_information":[{"code":"3468900001","type":"CDM"},{"code":"0689","type":"RC"}],"standard_charges":[{"minimum":302.08,"maximum":906.24,"gross_charge":944,"discounted_cash":547.52,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":398,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":896.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":906.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":689.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":783.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":689.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":453.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":327.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":302.08,"methodology":"fee schedule"}]}]},{"description":"TRAUMA ACTIVATION WO CRIT CARE","code_information":[{"code":"3468900002","type":"CDM"},{"code":"0689","type":"RC"}],"standard_charges":[{"minimum":332.48,"maximum":997.44,"gross_charge":1039,"discounted_cash":602.62,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":398,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":987.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":997.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":758.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":862.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":758.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":498.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":360.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":332.48,"methodology":"fee schedule"}]}]},{"description":"TRAUMA ACT V PART TM W PRENOT","code_information":[{"code":"3468900005","type":"CDM"},{"code":"0689","type":"RC"}],"standard_charges":[{"minimum":320,"maximum":960,"gross_charge":1000,"discounted_cash":580,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":398,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":950,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":960,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":730,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":830,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":730,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":480,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":346.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":320,"methodology":"fee schedule"}]}]},{"description":"TRAUMA EVAL LVL V W PRENOT","code_information":[{"code":"3468900006","type":"CDM"},{"code":"0689","type":"RC"}],"standard_charges":[{"minimum":160,"maximum":480,"gross_charge":500,"discounted_cash":290,"setting":"outpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":398,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":475,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":480,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":365,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":415,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":365,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":240,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":173.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":160,"methodology":"fee schedule"}]}]},{"description":"OTHER BACK AND NECK DISORDERS FRACTURES AND INJURIES","code_information":[{"code":"3471","type":"APR-DRG"}],"standard_charges":[{"minimum":16596,"maximum":16596,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16596,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PHASE 1 RECOVERY 15 MINS","code_information":[{"code":"3471000013","type":"CDM"},{"code":"0710","type":"RC"}],"standard_charges":[{"minimum":144,"maximum":432,"gross_charge":450,"discounted_cash":261,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":427.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":432,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":328.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":373.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":328.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":216,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":156.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"}]}]},{"description":"PHASE 2 RECOVERY-1ST 60 MINS","code_information":[{"code":"3471000014","type":"CDM"},{"code":"0710","type":"RC"}],"standard_charges":[{"minimum":59.52,"maximum":178.56,"gross_charge":186,"discounted_cash":107.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":176.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":178.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":154.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":135.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":89.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":64.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":59.52,"methodology":"fee schedule"}]}]},{"description":"PHASE 2-RECOVERY ADDL 15 MINS","code_information":[{"code":"3471000015","type":"CDM"},{"code":"0710","type":"RC"}],"standard_charges":[{"minimum":29.76,"maximum":89.28,"gross_charge":93,"discounted_cash":53.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":88.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":89.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":67.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":67.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.26,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":29.76,"methodology":"fee schedule"}]}]},{"description":"EXTENDED RECOVERY HOURLY MS","code_information":[{"code":"3471010100","type":"CDM"},{"code":"0710","type":"RC"}],"standard_charges":[{"minimum":17.92,"maximum":53.76,"gross_charge":56,"discounted_cash":32.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":53.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":53.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":17.92,"methodology":"fee schedule"}]}]},{"description":"EXTENDED RECOVERY 1ST HOUR MS","code_information":[{"code":"3471010200","type":"CDM"},{"code":"0710","type":"RC"}],"standard_charges":[{"minimum":105.92,"maximum":317.76,"gross_charge":331,"discounted_cash":191.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":314.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":317.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":241.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":274.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":241.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":114.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":105.92,"methodology":"fee schedule"}]}]},{"description":"PHASE I REC INIT 30 MIN PACU","code_information":[{"code":"3471010300","type":"CDM"},{"code":"0710","type":"RC"}],"standard_charges":[{"minimum":151.36,"maximum":454.08,"gross_charge":473,"discounted_cash":274.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":449.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":454.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":345.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":392.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":345.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":227.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":164.04,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":151.36,"methodology":"fee schedule"}]}]},{"description":"PHASE I REC ADDL 15 MINS PACU","code_information":[{"code":"3471010301","type":"CDM"},{"code":"0710","type":"RC"}],"standard_charges":[{"minimum":75.52,"maximum":226.56,"gross_charge":236,"discounted_cash":136.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":224.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":226.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":172.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":195.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":172.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":81.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":75.52,"methodology":"fee schedule"}]}]},{"description":"PHASE II REC INIT 30 MIN ACU","code_information":[{"code":"3471010302","type":"CDM"},{"code":"0710","type":"RC"}],"standard_charges":[{"minimum":56.32,"maximum":168.96,"gross_charge":176,"discounted_cash":102.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":167.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":168.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":128.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":146.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":128.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":84.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":61.04,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":56.32,"methodology":"fee schedule"}]}]},{"description":"PHASE II REC ADDL 15 MINS ACU","code_information":[{"code":"3471010303","type":"CDM"},{"code":"0710","type":"RC"}],"standard_charges":[{"minimum":28.16,"maximum":84.48,"gross_charge":88,"discounted_cash":51.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":83.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":84.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":64.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":73.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":64.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":42.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":30.52,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":28.16,"methodology":"fee schedule"}]}]},{"description":"EXTENDED REC INIT 60 MIN MS","code_information":[{"code":"3471010306","type":"CDM"},{"code":"0710","type":"RC"}],"standard_charges":[{"minimum":100.8,"maximum":302.4,"gross_charge":315,"discounted_cash":182.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":299.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":302.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":229.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":261.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":229.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":151.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":109.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":100.8,"methodology":"fee schedule"}]}]},{"description":"EXTENDED REC ADDL 60 MIN MS","code_information":[{"code":"3471010307","type":"CDM"},{"code":"0710","type":"RC"}],"standard_charges":[{"minimum":16.96,"maximum":50.88,"gross_charge":53,"discounted_cash":30.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":50.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":50.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":38.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":43.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":38.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":25.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":18.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.96,"methodology":"fee schedule"}]}]},{"description":"OTHER BACK AND NECK DISORDERS FRACTURES AND INJURIES","code_information":[{"code":"3472","type":"APR-DRG"}],"standard_charges":[{"minimum":23134,"maximum":23134,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23134,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRAY SAFE-T PLUS THORACENTESIS","code_information":[{"code":"347203","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":100.72,"maximum":132.46,"gross_charge":137.97,"discounted_cash":80.03,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":131.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":132.46,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":100.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":114.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":100.72,"methodology":"fee schedule"}]}]},{"description":"TRAY SAFE-T PLUS THORACENTESIS","code_information":[{"code":"347203","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":44.16,"maximum":132.46,"gross_charge":137.97,"discounted_cash":80.03,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":131.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":132.46,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":100.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":114.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":100.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":66.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":47.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":44.16,"methodology":"fee schedule"}]}]},{"description":"OTHER BACK AND NECK DISORDERS FRACTURES AND INJURIES","code_information":[{"code":"3473","type":"APR-DRG"}],"standard_charges":[{"minimum":31308,"maximum":31308,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31308,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RHYTHM STRIP","code_information":[{"code":"3473000006","type":"CDM"},{"code":"0730","type":"RC"}],"standard_charges":[{"minimum":7.04,"maximum":21.12,"gross_charge":22,"discounted_cash":12.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":20.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":21.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":10.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.04,"methodology":"fee schedule"}]}]},{"description":"EKG 12 LEAD TRACE MS","code_information":[{"code":"3473000007","type":"CDM"},{"code":"0730","type":"RC"}],"standard_charges":[{"minimum":73.92,"maximum":221.76,"gross_charge":231,"discounted_cash":133.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":219.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":221.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":168.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":191.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":168.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":110.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":80.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":73.92,"methodology":"fee schedule"}]}]},{"description":"ELECTROCARDIOGRAM TRACING CLI","code_information":[{"code":"3473000010","type":"CDM"},{"code":"0730","type":"RC"}],"standard_charges":[{"minimum":5.76,"maximum":17.28,"gross_charge":18,"discounted_cash":10.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":17.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":17.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.76,"methodology":"fee schedule"}]}]},{"description":"HOLTER MONITOR","code_information":[{"code":"3473100001","type":"CDM"},{"code":"0731","type":"RC"}],"standard_charges":[{"minimum":110.72,"maximum":332.16,"gross_charge":346,"discounted_cash":200.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":328.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":332.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":252.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":287.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":252.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":166.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":120,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":110.72,"methodology":"fee schedule"}]}]},{"description":"EVENT MARKER","code_information":[{"code":"3473100002","type":"CDM"},{"code":"0731","type":"RC"}],"standard_charges":[{"minimum":65.92,"maximum":197.76,"gross_charge":206,"discounted_cash":119.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":195.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":197.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":170.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":71.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":65.92,"methodology":"fee schedule"}]}]},{"description":"HOLT MON HOOK-UP REC & D","code_information":[{"code":"3473100003","type":"CDM"},{"code":"0731","type":"RC"}],"standard_charges":[{"minimum":90.24,"maximum":270.72,"gross_charge":282,"discounted_cash":163.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":267.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":270.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":205.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":234.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":205.86,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":135.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":97.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":90.24,"methodology":"fee schedule"}]}]},{"description":"NON-STRESS TEST","code_information":[{"code":"3473200001","type":"CDM"},{"code":"0920","type":"RC"}],"standard_charges":[{"minimum":168.32,"maximum":504.96,"gross_charge":526,"discounted_cash":305.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":499.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":504.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":383.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":436.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":383.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":252.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":182.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":168.32,"methodology":"fee schedule"}]}]},{"description":"OTHER BACK AND NECK DISORDERS FRACTURES AND INJURIES","code_information":[{"code":"3474","type":"APR-DRG"}],"standard_charges":[{"minimum":43550,"maximum":43550,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43550,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EEG SLEEP DEPRIVED**","code_information":[{"code":"3474000003","type":"CDM"},{"code":"0740","type":"RC"}],"standard_charges":[{"minimum":765.76,"maximum":2297.28,"gross_charge":2393,"discounted_cash":1387.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2273.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2297.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1746.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1986.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1746.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1148.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":829.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":765.76,"methodology":"fee schedule"}]}]},{"description":"COLONOSCPY W POLYP HOT BX FORC","code_information":[{"code":"3475000003","type":"CDM"},{"code":"0750","type":"RC"}],"standard_charges":[{"minimum":631.04,"maximum":1893.12,"gross_charge":1972,"discounted_cash":1143.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1873.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1893.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1439.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1636.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1439.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":946.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":683.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":631.04,"methodology":"fee schedule"}]}]},{"description":"FLEX SIG","code_information":[{"code":"3475000006","type":"CDM"},{"code":"0750","type":"RC"}],"standard_charges":[{"minimum":400.96,"maximum":1202.88,"gross_charge":1253,"discounted_cash":726.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1190.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1202.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":914.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1039.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":914.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":601.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":434.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":400.96,"methodology":"fee schedule"}]}]},{"description":"OPERATIVE UGI ENDOSCOPY","code_information":[{"code":"3475000007","type":"CDM"},{"code":"0750","type":"RC"}],"standard_charges":[{"minimum":648.32,"maximum":1944.96,"gross_charge":2026,"discounted_cash":1175.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1924.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1944.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1478.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1681.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1478.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":972.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":702.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":648.32,"methodology":"fee schedule"}]}]},{"description":"COLONOSCOPY VIA STOMA","code_information":[{"code":"3475000010","type":"CDM"},{"code":"0750","type":"RC"}],"standard_charges":[{"minimum":679.68,"maximum":2039.04,"gross_charge":2124,"discounted_cash":1231.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2017.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2039.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1550.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1762.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1550.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1019.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":736.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":679.68,"methodology":"fee schedule"}]}]},{"description":"COLONOSCOPY W POLYP W SNARE","code_information":[{"code":"3475000019","type":"CDM"},{"code":"0750","type":"RC"}],"standard_charges":[{"minimum":733.44,"maximum":2200.32,"gross_charge":2292,"discounted_cash":1329.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2177.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2200.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1673.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1902.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1673.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1100.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":794.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":733.44,"methodology":"fee schedule"}]}]},{"description":"ILEOSCOPY VIA STOMA","code_information":[{"code":"3475010125","type":"CDM"},{"code":"0750","type":"RC"}],"standard_charges":[{"minimum":1067.52,"maximum":3202.56,"gross_charge":3336,"discounted_cash":1934.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3169.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3202.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2435.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2768.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2435.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1601.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1156.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1067.52,"methodology":"fee schedule"}]}]},{"description":"CONTROL NASAL HEMORRHAGE","code_information":[{"code":"3476100004","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":101.76,"maximum":305.28,"gross_charge":318,"discounted_cash":184.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":302.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":305.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":232.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":263.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":232.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":110.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":101.76,"methodology":"fee schedule"}]}]},{"description":"SHLDR DISLOC TX W/MNP ANE-SDC","code_information":[{"code":"3476100005","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1442.88,"maximum":4328.64,"gross_charge":4509,"discounted_cash":2615.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4283.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4328.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3291.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3742.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3291.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2164.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1563.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1442.88,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF TONSIL ABSCES","code_information":[{"code":"3476100007","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":200,"maximum":600,"gross_charge":625,"discounted_cash":362.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":593.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":600,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":456.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":518.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":456.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":300,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":216.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":200,"methodology":"fee schedule"}]}]},{"description":"IRRIG DRUG DELIVERY DEV ACU","code_information":[{"code":"3476100010","type":"CDM"},{"code":"0940","type":"RC"}],"standard_charges":[{"minimum":86.72,"maximum":260.16,"gross_charge":271,"discounted_cash":157.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":257.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":260.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":197.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":224.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":197.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":130.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":93.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":86.72,"methodology":"fee schedule"}]}]},{"description":"CLOS TRMT DIST RAD FX W/MANIP","code_information":[{"code":"3476100011","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1201.92,"maximum":3605.76,"gross_charge":3756,"discounted_cash":2178.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3568.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3605.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2741.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3117.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2741.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1802.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1302.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1201.92,"methodology":"fee schedule"}]}]},{"description":"BONE MARROW BIOPSY","code_information":[{"code":"3476100014","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1164.8,"maximum":3494.4,"gross_charge":3640,"discounted_cash":2111.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3458,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3494.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2657.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3021.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2657.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1747.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1262.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1164.8,"methodology":"fee schedule"}]}]},{"description":"NURSING E&M","code_information":[{"code":"3476100016","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":21.44,"maximum":64.32,"gross_charge":67,"discounted_cash":38.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":63.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":64.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":48.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":55.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":48.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":32.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":23.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":21.44,"methodology":"fee schedule"}]}]},{"description":"LUMBAR PUNCTURE DIAGNOSTIC ACU","code_information":[{"code":"3476100018","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":683.2,"maximum":2049.6,"gross_charge":2135,"discounted_cash":1238.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2028.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2049.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1558.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1772.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1558.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1024.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":740.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":683.2,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE OF SKIN ABSCESS","code_information":[{"code":"3476100019","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":156.48,"maximum":469.44,"gross_charge":489,"discounted_cash":283.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":464.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":469.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":356.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":405.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":356.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":234.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":169.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":156.48,"methodology":"fee schedule"}]}]},{"description":"IRRIG/LAVG/INSTL BLADDER ACU","code_information":[{"code":"3476100024","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":217.28,"maximum":651.84,"gross_charge":679,"discounted_cash":393.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":645.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":651.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":495.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":563.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":495.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":325.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":235.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":217.28,"methodology":"fee schedule"}]}]},{"description":"E&M BY NURSE-EXP PROB FOC","code_information":[{"code":"3476100029","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":37.76,"maximum":113.28,"gross_charge":118,"discounted_cash":68.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":112.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":113.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":86.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":86.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":40.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":37.76,"methodology":"fee schedule"}]}]},{"description":"E&M BY NURSE-PROB FOCUSED","code_information":[{"code":"3476100030","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":32,"maximum":96,"gross_charge":100,"discounted_cash":58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":34.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":32,"methodology":"fee schedule"}]}]},{"description":"E&M BY NURSE-COMPREHENSIV","code_information":[{"code":"3476100032","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":69.76,"maximum":209.28,"gross_charge":218,"discounted_cash":126.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":207.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":209.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":159.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":159.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":104.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":75.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":69.76,"methodology":"fee schedule"}]}]},{"description":"NG TUBE PLACEMENT","code_information":[{"code":"3476100034","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":342.4,"maximum":1027.2,"gross_charge":1070,"discounted_cash":620.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1016.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1027.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":781.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":888.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":781.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":513.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":371.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":342.4,"methodology":"fee schedule"}]}]},{"description":"E&M BY NURSE-DETAILED","code_information":[{"code":"3476100036","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":50.24,"maximum":150.72,"gross_charge":157,"discounted_cash":91.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":149.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":150.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":114.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":130.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":114.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":75.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":54.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":50.24,"methodology":"fee schedule"}]}]},{"description":"BLOOD DRAW ONLY FROM PORT ACU","code_information":[{"code":"3476100037","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":105.28,"maximum":315.84,"gross_charge":329,"discounted_cash":190.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":312.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":315.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":157.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":114.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":105.28,"methodology":"fee schedule"}]}]},{"description":"REMOVE FOREIGN BODY SIMP","code_information":[{"code":"3476100038","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":287.68,"maximum":863.04,"gross_charge":899,"discounted_cash":521.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":854.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":863.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":656.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":746.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":656.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":431.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":311.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":287.68,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE SKIN/TISSUE","code_information":[{"code":"3476100041","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":311.68,"maximum":935.04,"gross_charge":974,"discounted_cash":564.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":925.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":935.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":711.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":808.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":711.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":467.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":337.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":311.68,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE TISSUES/MUSCLE**","code_information":[{"code":"3476100042","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":488.96,"maximum":1466.88,"gross_charge":1528,"discounted_cash":886.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1451.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1466.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1115.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1268.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1115.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":733.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":529.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":488.96,"methodology":"fee schedule"}]}]},{"description":"DEBRIDE MUSCLE/BONE**","code_information":[{"code":"3476100043","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1349.12,"maximum":4047.36,"gross_charge":4216,"discounted_cash":2445.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4005.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4047.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3077.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3499.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3077.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2023.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1462.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1349.12,"methodology":"fee schedule"}]}]},{"description":"AVUL NAIL PLATE ADDTL","code_information":[{"code":"3476100045","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":50.56,"maximum":151.68,"gross_charge":158,"discounted_cash":91.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":150.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":151.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":115.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":115.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":54.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":50.56,"methodology":"fee schedule"}]}]},{"description":"CHEMICAL PLERUODESIS","code_information":[{"code":"3476100047","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":578.88,"maximum":1736.64,"gross_charge":1809,"discounted_cash":1049.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1718.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1736.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1320.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1501.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1320.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":868.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":627.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":578.88,"methodology":"fee schedule"}]}]},{"description":"DSG/DBRD SM BURN","code_information":[{"code":"3476100054","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":167.36,"maximum":502.08,"gross_charge":523,"discounted_cash":303.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":496.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":502.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":381.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":434.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":381.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":251.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":181.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":167.36,"methodology":"fee schedule"}]}]},{"description":"INTUBATE ENDO EMERGENT RT","code_information":[{"code":"3476100057","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":168.64,"maximum":505.92,"gross_charge":527,"discounted_cash":305.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":500.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":505.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":384.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":437.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":384.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":252.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":182.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":168.64,"methodology":"fee schedule"}]}]},{"description":"CHANGE OF WINDPIPE AIRWAY","code_information":[{"code":"3476100058","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":168.96,"maximum":506.88,"gross_charge":528,"discounted_cash":306.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":501.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":506.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":385.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":438.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":385.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":253.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":183.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":168.96,"methodology":"fee schedule"}]}]},{"description":"CLEARANCE OF AIRWAY","code_information":[{"code":"3476100059","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":176.32,"maximum":528.96,"gross_charge":551,"discounted_cash":319.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":523.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":528.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":402.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":457.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":402.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":264.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":191.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":176.32,"methodology":"fee schedule"}]}]},{"description":"HEART/LUNG RESUSCITATION","code_information":[{"code":"3476100060","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":627.84,"maximum":1883.52,"gross_charge":1962,"discounted_cash":1137.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1863.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1883.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1432.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1628.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1432.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":941.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":680.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":627.84,"methodology":"fee schedule"}]}]},{"description":"ARTHRO-HIP INJ CHG W/OUT ANEST","code_information":[{"code":"3476100062","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":126.08,"maximum":378.24,"gross_charge":394,"discounted_cash":228.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":374.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":378.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":287.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":327.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":287.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":136.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":126.08,"methodology":"fee schedule"}]}]},{"description":"INJ PROC CYSTO/VCUG","code_information":[{"code":"3476100063","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":147.52,"maximum":442.56,"gross_charge":461,"discounted_cash":267.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":437.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":442.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":336.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":382.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":336.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":221.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":159.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":147.52,"methodology":"fee schedule"}]}]},{"description":"SMPL RPR LAC 2.5/LESS","code_information":[{"code":"3476100071","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":165.76,"maximum":497.28,"gross_charge":518,"discounted_cash":300.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":492.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":497.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":378.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":429.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":378.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":248.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":179.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":165.76,"methodology":"fee schedule"}]}]},{"description":"CONTROL NOSEBLD POST INIT","code_information":[{"code":"3476100073","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":99.84,"maximum":299.52,"gross_charge":312,"discounted_cash":180.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":296.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":299.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":227.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":258.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":227.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":149.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":108.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":99.84,"methodology":"fee schedule"}]}]},{"description":"CONTROL NOSEBLD POST SUB","code_information":[{"code":"3476100074","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":168.96,"maximum":506.88,"gross_charge":528,"discounted_cash":306.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":501.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":506.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":385.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":438.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":385.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":253.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":183.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":168.96,"methodology":"fee schedule"}]}]},{"description":"CLOS TRMT SHOULDER DISLOC-SDC","code_information":[{"code":"3476100075","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":225.28,"maximum":675.84,"gross_charge":704,"discounted_cash":408.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":668.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":675.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":513.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":584.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":513.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":337.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":244.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":225.28,"methodology":"fee schedule"}]}]},{"description":"NEG PRESSURE WOUND TRT<50CM","code_information":[{"code":"3476100076","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":90.88,"maximum":272.64,"gross_charge":284,"discounted_cash":164.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":269.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":272.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":207.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":235.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":207.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":136.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":98.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":90.88,"methodology":"fee schedule"}]}]},{"description":"CLOS TX CLAVICULAR FX","code_information":[{"code":"3476100083","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":229.76,"maximum":689.28,"gross_charge":718,"discounted_cash":416.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":682.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":689.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":524.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":595.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":524.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":344.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":249.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":229.76,"methodology":"fee schedule"}]}]},{"description":"MULTILAYER COMPRESSIONS SYSTEM","code_information":[{"code":"3476100085","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":142.72,"maximum":428.16,"gross_charge":446,"discounted_cash":258.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":423.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":428.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":325.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":370.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":325.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":214.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":154.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":142.72,"methodology":"fee schedule"}]}]},{"description":"EXC BENIGN LESION 2.1 TO 3.0CM","code_information":[{"code":"3476100086","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":573.76,"maximum":1721.28,"gross_charge":1793,"discounted_cash":1039.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1703.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1721.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1308.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1488.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1308.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":860.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":621.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":573.76,"methodology":"fee schedule"}]}]},{"description":"CATH INSERT INDWELL COMP ACU","code_information":[{"code":"3476100100","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":128.96,"maximum":386.88,"gross_charge":403,"discounted_cash":233.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":382.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":386.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":294.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":334.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":294.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":193.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":139.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":128.96,"methodology":"fee schedule"}]}]},{"description":"REM IMPL ART INF PUMP ACU","code_information":[{"code":"3476110020","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":2481.28,"maximum":7443.84,"gross_charge":7754,"discounted_cash":4497.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7366.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7443.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5660.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6435.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5660.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3721.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2689.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2481.28,"methodology":"fee schedule"}]}]},{"description":"BLOOD DRAW ONLY FROM PICC ACU","code_information":[{"code":"3476110100","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":97.92,"maximum":293.76,"gross_charge":306,"discounted_cash":177.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":290.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":293.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":223.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":253.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":223.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":106.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":97.92,"methodology":"fee schedule"}]}]},{"description":"BLADDER INSTILL AGENT ACU","code_information":[{"code":"3476110101","type":"CDM"},{"code":"0761","type":"RC"}],"standard_charges":[{"minimum":234.88,"maximum":704.64,"gross_charge":734,"discounted_cash":425.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":697.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":704.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":535.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":609.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":535.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":352.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":254.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":234.88,"methodology":"fee schedule"}]}]},{"description":"VACCINE ADMIN FLU ACU","code_information":[{"code":"3477100100","type":"CDM"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":43.2,"maximum":129.6,"gross_charge":135,"discounted_cash":78.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":128.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":129.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":98.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":112.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":98.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":64.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":46.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":43.2,"methodology":"fee schedule"}]}]},{"description":"VACCINE ADMIN OTHER ACU","code_information":[{"code":"3477100110","type":"CDM"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":44.8,"maximum":134.4,"gross_charge":140,"discounted_cash":81.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":133,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":134.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":102.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":116.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":102.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":67.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":48.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":44.8,"methodology":"fee schedule"}]}]},{"description":"VACCINE ADMIN ADDL EACH ACU","code_information":[{"code":"3477100115","type":"CDM"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":22.08,"maximum":66.24,"gross_charge":69,"discounted_cash":40.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":65.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":66.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":50.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":57.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":50.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":33.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":23.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"}]}]},{"description":"ADMN SARSCOV2 VACC 1 DOSE EMP","code_information":[{"code":"3477100504","type":"CDM"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":43.52,"maximum":130.56,"gross_charge":136,"discounted_cash":78.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":129.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":130.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":99.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":112.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":99.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":47.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":43.52,"methodology":"fee schedule"}]}]},{"description":"ADM TOCILIZU COVID-19 1ST MS","code_information":[{"code":"3477110260","type":"CDM"},{"code":"0771","type":"RC"}],"standard_charges":[{"minimum":228.48,"maximum":685.44,"gross_charge":714,"discounted_cash":414.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":678.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":685.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":521.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":592.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":521.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":342.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":247.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":228.48,"methodology":"fee schedule"}]}]},{"description":"TELEHEALTH ORIGIN FEE MNT","code_information":[{"code":"3478000001","type":"CDM"},{"code":"0780","type":"RC"}],"standard_charges":[{"minimum":39.68,"maximum":119.04,"gross_charge":124,"discounted_cash":71.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":117.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":102.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":43.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":39.68,"methodology":"fee schedule"}]}]},{"description":"HEMODIALYSIS TREATMENT","code_information":[{"code":"3482000001","type":"CDM"},{"code":"0801","type":"RC"}],"standard_charges":[{"minimum":342.08,"maximum":1026.24,"gross_charge":1069,"discounted_cash":620.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1015.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1026.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":780.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":887.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":780.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":513.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":370.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":342.08,"methodology":"fee schedule"}]}]},{"description":"GWIRE TREPHINE","code_information":[{"code":"349049","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":403.69,"maximum":530.88,"gross_charge":553,"discounted_cash":320.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":525.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":530.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":403.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":458.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":403.69,"methodology":"fee schedule"}]}]},{"description":"GWIRE TREPHINE","code_information":[{"code":"349049","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":176.96,"maximum":530.88,"gross_charge":553,"discounted_cash":320.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":525.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":530.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":403.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":458.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":403.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":265.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":191.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":176.96,"methodology":"fee schedule"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE","code_information":[{"code":"3491","type":"APR-DRG"}],"standard_charges":[{"minimum":9148,"maximum":9148,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9148,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE","code_information":[{"code":"3492","type":"APR-DRG"}],"standard_charges":[{"minimum":12955,"maximum":12955,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12955,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BLADDER SCAN POST VOID MS","code_information":[{"code":"3492011060","type":"CDM"},{"code":"0920","type":"RC"}],"standard_charges":[{"minimum":57.6,"maximum":172.8,"gross_charge":180,"discounted_cash":104.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":171,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":172.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":131.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":149.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":131.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":62.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":57.6,"methodology":"fee schedule"}]}]},{"description":"EXTREM STUDY 3+ LVLS ACU","code_information":[{"code":"3492110105","type":"CDM"},{"code":"0921","type":"RC"}],"standard_charges":[{"minimum":246.72,"maximum":740.16,"gross_charge":771,"discounted_cash":447.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":732.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":740.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":562.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":639.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":562.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":370.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":267.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":246.72,"methodology":"fee schedule"}]}]},{"description":"EXTREM STUDY 1-2 LVLS ACU","code_information":[{"code":"3492110115","type":"CDM"},{"code":"0921","type":"RC"}],"standard_charges":[{"minimum":162.88,"maximum":488.64,"gross_charge":509,"discounted_cash":295.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":483.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":488.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":371.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":422.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":371.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":244.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":176.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":162.88,"methodology":"fee schedule"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE","code_information":[{"code":"3493","type":"APR-DRG"}],"standard_charges":[{"minimum":23679,"maximum":23679,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23679,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE","code_information":[{"code":"3494","type":"APR-DRG"}],"standard_charges":[{"minimum":50245,"maximum":50245,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50245,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PHLEBOTOMY","code_information":[{"code":"3494000001","type":"CDM"},{"code":"0940","type":"RC"}],"standard_charges":[{"minimum":214.4,"maximum":643.2,"gross_charge":670,"discounted_cash":388.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":636.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":643.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":489.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":556.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":489.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":321.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":232.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":214.4,"methodology":"fee schedule"}]}]},{"description":"ABD PARACENTESIS W GUIDE ACU","code_information":[{"code":"3494000002","type":"CDM"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":824.32,"maximum":2472.96,"gross_charge":2576,"discounted_cash":1494.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2447.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2472.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1880.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2138.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1880.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1236.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":893.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":824.32,"methodology":"fee schedule"}]}]},{"description":"CATH INSERT STRAIGHT MS","code_information":[{"code":"3494001050","type":"CDM"},{"code":"0940","type":"RC"}],"standard_charges":[{"minimum":105.28,"maximum":315.84,"gross_charge":329,"discounted_cash":190.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":312.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":315.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":157.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":114.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":105.28,"methodology":"fee schedule"}]}]},{"description":"CATH INSERT INDWELL MS","code_information":[{"code":"3494001055","type":"CDM"},{"code":"0940","type":"RC"}],"standard_charges":[{"minimum":99.52,"maximum":298.56,"gross_charge":311,"discounted_cash":180.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":295.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":298.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":227.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":258.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":227.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":149.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":107.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":99.52,"methodology":"fee schedule"}]}]},{"description":"INJ SUBQ/IM MS","code_information":[{"code":"3494010100","type":"CDM"},{"code":"0940","type":"RC"}],"standard_charges":[{"minimum":71.04,"maximum":213.12,"gross_charge":222,"discounted_cash":128.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":210.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":213.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":162.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":184.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":162.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":106.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":76.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"}]}]},{"description":"CATH INSERT INDWELL COMP MS","code_information":[{"code":"3494011060","type":"CDM"},{"code":"0940","type":"RC"}],"standard_charges":[{"minimum":128.96,"maximum":386.88,"gross_charge":403,"discounted_cash":233.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":382.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":386.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":294.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":334.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":294.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":193.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":139.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":128.96,"methodology":"fee schedule"}]}]},{"description":"CATH BLADDER COMPLEX ER","code_information":[{"code":"3494011065","type":"CDM"},{"code":"0450","type":"RC"}],"standard_charges":[{"minimum":128.96,"maximum":386.88,"gross_charge":403,"discounted_cash":233.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":382.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":386.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":294.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":334.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":294.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":193.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":139.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":128.96,"methodology":"fee schedule"}]}]},{"description":"MNT REASS INDIVID EA 15MIN","code_information":[{"code":"3494200001","type":"CDM"},{"code":"0942","type":"RC"}],"standard_charges":[{"minimum":25.28,"maximum":75.84,"gross_charge":79,"discounted_cash":45.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":75.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":57.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":65.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":57.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":37.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":27.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":25.28,"methodology":"fee schedule"}]}]},{"description":"MNT REASS GROUP EA 30 MIN","code_information":[{"code":"3494200002","type":"CDM"},{"code":"0942","type":"RC"}],"standard_charges":[{"minimum":14.72,"maximum":44.16,"gross_charge":46,"discounted_cash":26.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":43.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":44.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":33.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":38.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":33.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":15.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":14.72,"methodology":"fee schedule"}]}]},{"description":"MNT INIT ASSESS IND EA 15MI","code_information":[{"code":"3494200003","type":"CDM"},{"code":"0942","type":"RC"}],"standard_charges":[{"minimum":46.08,"maximum":138.24,"gross_charge":144,"discounted_cash":83.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":136.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":138.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":105.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":119.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":105.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":69.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":49.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":46.08,"methodology":"fee schedule"}]}]},{"description":"MNT REASS INDIVID EA 15 MIN","code_information":[{"code":"3494200004","type":"CDM"},{"code":"0942","type":"RC"}],"standard_charges":[{"minimum":47.36,"maximum":142.08,"gross_charge":148,"discounted_cash":85.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":140.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":51.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.36,"methodology":"fee schedule"}]}]},{"description":"MNT GROUP EA 30 MIN","code_information":[{"code":"3494200005","type":"CDM"},{"code":"0942","type":"RC"}],"standard_charges":[{"minimum":22.08,"maximum":66.24,"gross_charge":69,"discounted_cash":40.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":65.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":66.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":50.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":57.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":50.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":33.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":23.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"}]}]},{"description":"DSME/T INDIVID EA 30 MIN","code_information":[{"code":"3494200006","type":"CDM"},{"code":"0942","type":"RC"}],"standard_charges":[{"minimum":44.16,"maximum":132.48,"gross_charge":138,"discounted_cash":80.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":131.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":132.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":100.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":114.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":100.74,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":66.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":47.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":44.16,"methodology":"fee schedule"}]}]},{"description":"GLUCOSE MONITORING CONT <72HRS","code_information":[{"code":"3494210100","type":"CDM"},{"code":"0942","type":"RC"}],"standard_charges":[{"minimum":198.4,"maximum":595.2,"gross_charge":620,"discounted_cash":359.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":589,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":595.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":452.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":514.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":452.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":297.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":215.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":198.4,"methodology":"fee schedule"}]}]},{"description":"PHASE 1 OR 2 CARDIAC REHAB","code_information":[{"code":"3494300002","type":"CDM"},{"code":"0943","type":"RC"}],"standard_charges":[{"minimum":57.92,"maximum":173.76,"gross_charge":181,"discounted_cash":104.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":171.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":173.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":150.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":62.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":57.92,"methodology":"fee schedule"}]}]},{"description":"PHASE III-INITIAL VISIT","code_information":[{"code":"3494300003","type":"CDM"},{"code":"0943","type":"RC"}],"standard_charges":[{"minimum":23.36,"maximum":70.08,"gross_charge":73,"discounted_cash":42.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":69.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":70.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":53.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":60.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":53.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":35.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":25.32,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":23.36,"methodology":"fee schedule"}]}]},{"description":"CARD REHAB/MONTH 6 VISITS &","code_information":[{"code":"3494300004","type":"CDM"},{"code":"0943","type":"RC"}],"standard_charges":[{"minimum":18.24,"maximum":54.72,"gross_charge":57,"discounted_cash":33.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":54.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":54.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":41.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":47.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":41.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":27.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.24,"methodology":"fee schedule"}]}]},{"description":"PHASE III-PARTIAL UP TO 5 VIS","code_information":[{"code":"3494300005","type":"CDM"},{"code":"0943","type":"RC"}],"standard_charges":[{"minimum":10.88,"maximum":32.64,"gross_charge":34,"discounted_cash":19.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":32.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":32.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":24.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":28.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":24.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":16.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":11.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":10.88,"methodology":"fee schedule"}]}]},{"description":"CARD REHAB W/OUT CONT ECG","code_information":[{"code":"3494300006","type":"CDM"},{"code":"0943","type":"RC"}],"standard_charges":[{"minimum":37.76,"maximum":113.28,"gross_charge":118,"discounted_cash":68.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":112.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":113.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":86.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":86.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":40.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":37.76,"methodology":"fee schedule"}]}]},{"description":"PHY/QHP OP PULM RHB W/MNTR 1HR","code_information":[{"code":"3494800001","type":"CDM"},{"code":"0948","type":"RC"}],"standard_charges":[{"minimum":83.52,"maximum":250.56,"gross_charge":261,"discounted_cash":151.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":247.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":250.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":190.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":216.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":190.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":125.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":83.52,"methodology":"fee schedule"}]}]},{"description":"P REHAB TO INCRE STRENGTH 15","code_information":[{"code":"3494800002","type":"CDM"},{"code":"0410","type":"RC"}],"standard_charges":[{"minimum":32.64,"maximum":97.92,"gross_charge":102,"discounted_cash":59.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":96.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":97.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":74.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":84.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":74.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":48.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":35.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":32.64,"methodology":"fee schedule"}]}]},{"description":"PULM REHAB/MONTHLY SP CHG","code_information":[{"code":"3494800005","type":"CDM"},{"code":"0948","type":"RC"}],"standard_charges":[{"minimum":34.24,"maximum":102.72,"gross_charge":107,"discounted_cash":62.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":101.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":102.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":78.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":88.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":78.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":51.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":37.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":34.24,"methodology":"fee schedule"}]}]},{"description":"MULT SLEEP LATENCY MSLT PF","code_information":[{"code":"3496010101","type":"CDM"},{"code":"0960","type":"RC"}],"standard_charges":[{"minimum":53.12,"maximum":159.36,"gross_charge":166,"discounted_cash":96.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":157.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":159.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":121.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":121.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":57.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":53.12,"methodology":"fee schedule"}]}]},{"description":"SLEEP STUDY ATTENDED PF","code_information":[{"code":"3496010102","type":"CDM"},{"code":"0960","type":"RC"}],"standard_charges":[{"minimum":55.04,"maximum":165.12,"gross_charge":172,"discounted_cash":99.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":163.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":165.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":125.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":142.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":125.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":82.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":59.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":55.04,"methodology":"fee schedule"}]}]},{"description":"FULL POLYSOM ATTENDED PF","code_information":[{"code":"3496010103","type":"CDM"},{"code":"0960","type":"RC"}],"standard_charges":[{"minimum":109.76,"maximum":329.28,"gross_charge":343,"discounted_cash":198.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":325.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":118.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.76,"methodology":"fee schedule"}]}]},{"description":"SLEEP STUDY W BIPAP/CPAP PF","code_information":[{"code":"3496010104","type":"CDM"},{"code":"0960","type":"RC"}],"standard_charges":[{"minimum":113.92,"maximum":341.76,"gross_charge":356,"discounted_cash":206.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":338.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":341.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":259.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":295.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":259.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":123.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":113.92,"methodology":"fee schedule"}]}]},{"description":"ANES FOR INTRAPERITONEAL PROC","code_information":[{"code":"3496400003","type":"CDM"},{"code":"0964","type":"RC"}],"standard_charges":[{"minimum":122,"maximum":292.8,"gross_charge":305,"discounted_cash":176.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":289.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":292.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":222.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":253.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":222.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":124.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":122,"methodology":"fee schedule"}]}]},{"description":"00790QZ- ANES PER MINUTE","code_information":[{"code":"3496400005","type":"CDM"},{"code":"0964","type":"RC"}],"standard_charges":[{"minimum":7.2,"maximum":17.28,"gross_charge":18,"discounted_cash":10.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":17.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":17.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.2,"methodology":"fee schedule"}]}]},{"description":"EPIDURAL INJ-SPINE BY CRNA","code_information":[{"code":"3496400098","type":"CDM"},{"code":"0964","type":"RC"}],"standard_charges":[{"minimum":512.4,"maximum":1229.76,"gross_charge":1281,"discounted_cash":742.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1216.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1229.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":935.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1063.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":935.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":614.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":522.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":512.4,"methodology":"fee schedule"}]}]},{"description":"ANES FOR VITREORETINAL SURG","code_information":[{"code":"3496400131","type":"CDM"},{"code":"0964","type":"RC"}],"standard_charges":[{"minimum":111.6,"maximum":267.84,"gross_charge":279,"discounted_cash":161.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":265.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":267.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":203.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":231.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":203.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":133.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":113.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":111.6,"methodology":"fee schedule"}]}]},{"description":"COLONOSCPY VIA STOMA W BIOP PF","code_information":[{"code":"3497500015","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":320.64,"maximum":961.92,"gross_charge":1002,"discounted_cash":581.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":951.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":961.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":731.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":831.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":731.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":480.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":347.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":320.64,"methodology":"fee schedule"}]}]},{"description":"EXC B9 TR/ARM/LEG >4CM CLI OR","code_information":[{"code":"3497500183","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":287.36,"maximum":862.08,"gross_charge":898,"discounted_cash":520.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":853.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":862.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":655.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":745.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":655.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":431.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":311.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":287.36,"methodology":"fee schedule"}]}]},{"description":"EXC H-F-NK-SP B9+MARG 2.1-3 OR","code_information":[{"code":"3497500380","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":187.2,"maximum":561.6,"gross_charge":585,"discounted_cash":339.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":555.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":561.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":427.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":485.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":427.05,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":280.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":202.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":187.2,"methodology":"fee schedule"}]}]},{"description":"CIRCUM W/ REGION BLOCK CLI OR","code_information":[{"code":"3497501010","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":133.44,"maximum":400.32,"gross_charge":417,"discounted_cash":241.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":396.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":400.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":304.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":346.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":304.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":200.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":144.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":133.44,"methodology":"fee schedule"}]}]},{"description":"AVULSION NAIL PLATE SGL CLI OR","code_information":[{"code":"3497510101","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":84.8,"maximum":254.4,"gross_charge":265,"discounted_cash":153.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":254.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":193.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":219.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":193.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":127.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":91.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":84.8,"methodology":"fee schedule"}]}]},{"description":"AVUL NAIL PLATE EA ADD CLI OR","code_information":[{"code":"3497510102","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":29.44,"maximum":88.32,"gross_charge":92,"discounted_cash":53.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":87.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":88.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":67.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":76.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":67.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":31.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":29.44,"methodology":"fee schedule"}]}]},{"description":"DIAG LAPARO ABD/PERI/OMENT PF","code_information":[{"code":"3497510103","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":289.6,"maximum":868.8,"gross_charge":905,"discounted_cash":524.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":859.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":868.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":660.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":751.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":660.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":434.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":313.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":289.6,"methodology":"fee schedule"}]}]},{"description":"INS DEVICE CV W PRT>5YR CLI OR","code_information":[{"code":"3497510104","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":885.12,"maximum":2655.36,"gross_charge":2766,"discounted_cash":1604.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2627.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2655.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2019.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2295.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2019.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1327.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":959.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":885.12,"methodology":"fee schedule"}]}]},{"description":"PUNCH BX SKIN SINGLE LESION OR","code_information":[{"code":"3497510106","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":112.64,"maximum":337.92,"gross_charge":352,"discounted_cash":204.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":334.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":337.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":256.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":292.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":256.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":168.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":122.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":112.64,"methodology":"fee schedule"}]}]},{"description":"EXC NECK LES SC< 3CM OR PF","code_information":[{"code":"3497510108","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":391.04,"maximum":1173.12,"gross_charge":1222,"discounted_cash":708.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1160.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1173.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":892.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1014.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":892.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":586.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":423.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":391.04,"methodology":"fee schedule"}]}]},{"description":"SURG DX EXAM ANORECTAL CLI OR","code_information":[{"code":"3497510109","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":93.12,"maximum":279.36,"gross_charge":291,"discounted_cash":168.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":276.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":279.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":212.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":241.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":212.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":139.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":100.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":93.12,"methodology":"fee schedule"}]}]},{"description":"BX TISSUE ARM/ELBOW SUPER PF","code_information":[{"code":"3497510115","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":234.88,"maximum":704.64,"gross_charge":734,"discounted_cash":425.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":697.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":704.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":535.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":609.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":535.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":352.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":254.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":234.88,"methodology":"fee schedule"}]}]},{"description":"REPAIR ING HERNIA REDUCE OR","code_information":[{"code":"3497510125","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":560.96,"maximum":1682.88,"gross_charge":1753,"discounted_cash":1016.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1665.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1682.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1279.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1454.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1279.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":841.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":607.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":560.96,"methodology":"fee schedule"}]}]},{"description":"CHANGE CYSTOSTOMY SIMPLE PF","code_information":[{"code":"3497510128","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":72.64,"maximum":217.92,"gross_charge":227,"discounted_cash":131.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":215.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":188.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.64,"methodology":"fee schedule"}]}]},{"description":"COLONOSCOPY & BIOPSY","code_information":[{"code":"3497510130","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":388.8,"maximum":1166.4,"gross_charge":1215,"discounted_cash":704.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1154.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1166.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":886.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1008.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":886.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":583.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":421.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":388.8,"methodology":"fee schedule"}]}]},{"description":"DRAINAGE SKIN ABSCESS SMPLE OR","code_information":[{"code":"3497510132","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":94.72,"maximum":284.16,"gross_charge":296,"discounted_cash":171.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":281.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":284.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":216.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":245.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":216.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":102.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":94.72,"methodology":"fee schedule"}]}]},{"description":"COLONOSCOPY LESION REMOV-SNARE","code_information":[{"code":"3497510135","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":406.72,"maximum":1220.16,"gross_charge":1271,"discounted_cash":737.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1207.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1220.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":927.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1054.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":927.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":610.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":440.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":406.72,"methodology":"fee schedule"}]}]},{"description":"COLONOSCOPY DIAGNOSTIC","code_information":[{"code":"3497510140","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":305.92,"maximum":917.76,"gross_charge":956,"discounted_cash":554.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":908.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":917.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":697.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":793.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":697.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":458.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":331.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":305.92,"methodology":"fee schedule"}]}]},{"description":"SIGMOIDOSCOPY W/TUMR REMO","code_information":[{"code":"3497510145","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":241.6,"maximum":724.8,"gross_charge":755,"discounted_cash":437.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":717.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":724.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":551.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":626.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":551.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":362.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":261.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":241.6,"methodology":"fee schedule"}]}]},{"description":"UPPER GI ENDOSCOPY DIAGNOSTIC","code_information":[{"code":"3497510150","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":261.12,"maximum":783.36,"gross_charge":816,"discounted_cash":473.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":775.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":783.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":595.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":677.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":595.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":391.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":282.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":261.12,"methodology":"fee schedule"}]}]},{"description":"UPPER GI ENDO BIOPSY","code_information":[{"code":"3497510155","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":336.96,"maximum":1010.88,"gross_charge":1053,"discounted_cash":610.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1000.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1010.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":768.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":873.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":768.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":505.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":365.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":336.96,"methodology":"fee schedule"}]}]},{"description":"SIGMOIDOSCOPY DIAG","code_information":[{"code":"3497510160","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":170.56,"maximum":511.68,"gross_charge":533,"discounted_cash":309.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":506.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":511.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":389.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":442.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":389.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":255.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":184.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":170.56,"methodology":"fee schedule"}]}]},{"description":"BONE MARROW BIOPSY","code_information":[{"code":"3497510165","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":151.04,"maximum":453.12,"gross_charge":472,"discounted_cash":273.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":448.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":453.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":344.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":391.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":344.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":226.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":163.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":151.04,"methodology":"fee schedule"}]}]},{"description":"BONE MARROW ASPIRATION","code_information":[{"code":"3497510170","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":145.92,"maximum":437.76,"gross_charge":456,"discounted_cash":264.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":433.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":437.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":332.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":378.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":332.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":218.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":158.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":145.92,"methodology":"fee schedule"}]}]},{"description":"CHANGE CYSTOSTOMY TUBE SUR","code_information":[{"code":"3497510175","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":117.76,"maximum":353.28,"gross_charge":368,"discounted_cash":213.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":349.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":353.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":268.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":305.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":268.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":127.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":117.76,"methodology":"fee schedule"}]}]},{"description":"FLEX SIGMOID W/BIOPSY","code_information":[{"code":"3497510180","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":257.92,"maximum":773.76,"gross_charge":806,"discounted_cash":467.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":765.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":773.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":588.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":668.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":588.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":386.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":279.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":257.92,"methodology":"fee schedule"}]}]},{"description":"EXC FACE MALIGNANT LESION","code_information":[{"code":"3497510185","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":285.12,"maximum":855.36,"gross_charge":891,"discounted_cash":516.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":846.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":855.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":650.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":739.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":650.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":427.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":309,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":285.12,"methodology":"fee schedule"}]}]},{"description":"EXC FACE MALIGNANT LESION","code_information":[{"code":"3497510190","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":243.2,"maximum":729.6,"gross_charge":760,"discounted_cash":440.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":722,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":729.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":554.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":630.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":554.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":364.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":263.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":243.2,"methodology":"fee schedule"}]}]},{"description":"EXC FACE BENIGN LESION","code_information":[{"code":"3497510195","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":194.56,"maximum":583.68,"gross_charge":608,"discounted_cash":352.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":577.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":583.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":443.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":504.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":443.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":291.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":210.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":194.56,"methodology":"fee schedule"}]}]},{"description":"CONTROL NOSEBLD POST INIT PF","code_information":[{"code":"3497510200","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":204.48,"maximum":613.44,"gross_charge":639,"discounted_cash":370.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":607.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":613.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":466.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":530.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":466.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":306.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":221.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":204.48,"methodology":"fee schedule"}]}]},{"description":"CHEMICAL CAUTERIZATION","code_information":[{"code":"3497510205","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":107.52,"maximum":322.56,"gross_charge":336,"discounted_cash":194.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":319.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":322.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":245.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":278.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":245.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":161.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":116.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":107.52,"methodology":"fee schedule"}]}]},{"description":"ENDOMETRIAL SAMPLING","code_information":[{"code":"3497510210","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":89.6,"maximum":268.8,"gross_charge":280,"discounted_cash":162.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":266,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":268.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":204.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":232.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":204.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":134.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":97.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":89.6,"methodology":"fee schedule"}]}]},{"description":"NAIL TRIMMING","code_information":[{"code":"3497510220","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":13.12,"maximum":39.36,"gross_charge":41,"discounted_cash":23.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.12,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-REMOVE ELBOW BURSA","code_information":[{"code":"3497510230","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":335.04,"maximum":1005.12,"gross_charge":1047,"discounted_cash":607.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":994.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1005.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":764.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":869.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":764.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":502.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":363.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":335.04,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-BPSY/RMVL LYMPH NODE","code_information":[{"code":"3497510235","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":469.12,"maximum":1407.36,"gross_charge":1466,"discounted_cash":850.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1392.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1407.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1070.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1216.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1070.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":703.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":508.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":469.12,"methodology":"fee schedule"}]}]},{"description":"COLONOSCOPY SUBMUC INJ CLI OR","code_information":[{"code":"3497510241","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":396.48,"maximum":1189.44,"gross_charge":1239,"discounted_cash":718.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1177.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1189.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":904.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1028.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":904.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":594.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":429.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":396.48,"methodology":"fee schedule"}]}]},{"description":"REM CVAD W/PMP TUNNELED OR PF","code_information":[{"code":"3497510250","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":195.84,"maximum":587.52,"gross_charge":612,"discounted_cash":354.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":581.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":587.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":446.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":507.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":446.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":293.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":212.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":195.84,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-DRAIN SKIN ABSCESS","code_information":[{"code":"3497510265","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":177.92,"maximum":533.76,"gross_charge":556,"discounted_cash":322.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":528.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":533.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":405.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":461.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":405.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":266.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":192.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":177.92,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-APPENDECTOMY","code_information":[{"code":"3497510270","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":679.36,"maximum":2038.08,"gross_charge":2123,"discounted_cash":1231.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2016.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2038.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1549.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1762.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1549.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1019.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":736.26,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":679.36,"methodology":"fee schedule"}]}]},{"description":"PHYS CHGS-PLACEMENT OF TUBE","code_information":[{"code":"3497510275","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":656.32,"maximum":1968.96,"gross_charge":2051,"discounted_cash":1189.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1948.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1968.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1497.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1702.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1497.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":984.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":711.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":656.32,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-REMV BRST LESION","code_information":[{"code":"3497510280","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":464.32,"maximum":1392.96,"gross_charge":1451,"discounted_cash":841.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1378.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1392.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1059.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1204.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1059.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":696.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":503.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":464.32,"methodology":"fee schedule"}]}]},{"description":"PHYS CHGS-LIG & DIV OF S. VEIN","code_information":[{"code":"3497510285","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":224.64,"maximum":673.92,"gross_charge":702,"discounted_cash":407.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":666.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":673.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":512.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":582.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":512.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":336.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":243.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":224.64,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-REMOVAL OF ANAL FISTU","code_information":[{"code":"3497510290","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":408,"maximum":1224,"gross_charge":1275,"discounted_cash":739.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1211.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1224,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":930.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1058.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":930.75,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":612,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":442.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":408,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-REPAIR ING HERNIA","code_information":[{"code":"3497510295","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":382.4,"maximum":1147.2,"gross_charge":1195,"discounted_cash":693.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1135.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1147.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":872.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":991.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":872.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":573.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":414.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":382.4,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-SKIN TISSUE REARRANGE","code_information":[{"code":"3497510300","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":590.4,"maximum":1771.2,"gross_charge":1845,"discounted_cash":1070.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1752.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1771.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1346.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1531.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1346.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":885.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":639.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":590.4,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-ESOPH ENDOSCOPYDIL","code_information":[{"code":"3497510305","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":944.64,"maximum":2833.92,"gross_charge":2952,"discounted_cash":1712.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2804.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2833.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2154.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2450.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2154.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1416.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1023.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":944.64,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-DEBRIDE SKIN/TISSUE","code_information":[{"code":"3497510310","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":69.12,"maximum":207.36,"gross_charge":216,"discounted_cash":125.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":205.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":207.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":157.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":179.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":157.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":74.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":69.12,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-BIOPSY/REM LYMPH NODE","code_information":[{"code":"3497510315","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":342.72,"maximum":1028.16,"gross_charge":1071,"discounted_cash":621.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1017.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1028.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":781.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":888.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":781.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":514.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":371.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":342.72,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-LAC RPR 2.6CM-7.5CM","code_information":[{"code":"3497510320","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":267.84,"maximum":803.52,"gross_charge":837,"discounted_cash":485.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":795.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":803.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":611.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":694.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":611.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":401.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":290.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":267.84,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-REMOVE BRST TISSUE","code_information":[{"code":"3497510325","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":453.44,"maximum":1360.32,"gross_charge":1417,"discounted_cash":821.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1346.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1360.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1034.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1176.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1034.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":680.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":491.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":453.44,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXC OF HYDROCELE","code_information":[{"code":"3497510335","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":337.28,"maximum":1011.84,"gross_charge":1054,"discounted_cash":611.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1001.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1011.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":769.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":874.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":769.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":505.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":365.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":337.28,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXCBENIGN LESION","code_information":[{"code":"3497510340","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":256.96,"maximum":770.88,"gross_charge":803,"discounted_cash":465.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":762.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":770.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":586.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":666.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":586.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":385.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":278.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":256.96,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-LAP CHOLE","code_information":[{"code":"3497510345","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":576.64,"maximum":1729.92,"gross_charge":1802,"discounted_cash":1045.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1711.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1729.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1315.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1495.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1315.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":864.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":624.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":576.64,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-BPSY/RMVL LYMPH NODES","code_information":[{"code":"3497510350","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":490.24,"maximum":1470.72,"gross_charge":1532,"discounted_cash":888.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1455.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1470.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1118.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1271.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1118.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":735.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":531.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":490.24,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXC OF BREAST LESION","code_information":[{"code":"3497510355","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":517.12,"maximum":1551.36,"gross_charge":1616,"discounted_cash":937.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1535.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1551.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1179.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1341.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1179.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":775.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":560.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":517.12,"methodology":"fee schedule"}]}]},{"description":"IMPL CENT VENOUS ACCESS DEVICE","code_information":[{"code":"3497510360","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":1141.12,"maximum":3423.36,"gross_charge":3566,"discounted_cash":2068.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3387.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3423.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2603.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2959.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2603.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1711.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1236.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1141.12,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-UGI W/REMOVAL OF FOB","code_information":[{"code":"3497510365","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":343.68,"maximum":1031.04,"gross_charge":1074,"discounted_cash":622.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1020.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1031.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":784.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":891.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":784.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":515.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":372.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":343.68,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-REMOVE FOREIGN BODY","code_information":[{"code":"3497510370","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":232.96,"maximum":698.88,"gross_charge":728,"discounted_cash":422.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":691.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":698.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":531.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":604.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":531.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":349.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":252.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":232.96,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-COMP DRAIN WOUND","code_information":[{"code":"3497510375","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":233.6,"maximum":700.8,"gross_charge":730,"discounted_cash":423.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":693.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":700.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":532.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":605.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":532.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":350.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":253.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":233.6,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-DIAG ANOSCOPY","code_information":[{"code":"3497510380","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":90.88,"maximum":272.64,"gross_charge":284,"discounted_cash":164.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":269.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":272.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":207.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":235.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":207.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":136.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":98.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":90.88,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-RPR ING HERNIA","code_information":[{"code":"3497510385","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":459.84,"maximum":1379.52,"gross_charge":1437,"discounted_cash":833.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1365.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1379.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1049.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1192.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1049.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":689.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":498.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":459.84,"methodology":"fee schedule"}]}]},{"description":"PHYS CHGS-FACE EXCISION","code_information":[{"code":"3497510390","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":157.76,"maximum":473.28,"gross_charge":493,"discounted_cash":285.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":468.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":473.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":359.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":409.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":359.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":236.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":170.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":157.76,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-LAPAROSCOPYFUNDOPLAS","code_information":[{"code":"3497510395","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":929.6,"maximum":2788.8,"gross_charge":2905,"discounted_cash":1684.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2759.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2788.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2120.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2411.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2120.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1394.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1007.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":929.6,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-ESPHAG ENDOSCOPY","code_information":[{"code":"3497510400","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":140.48,"maximum":421.44,"gross_charge":439,"discounted_cash":254.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":417.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":421.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":320.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":364.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":320.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":210.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":152.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":140.48,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-INCISE&DRAIN BLADDER","code_information":[{"code":"3497510405","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":263.68,"maximum":791.04,"gross_charge":824,"discounted_cash":477.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":782.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":791.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":601.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":683.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":601.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":395.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":285.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":263.68,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-HEMORRHOIDECTOMY","code_information":[{"code":"3497510410","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":470.08,"maximum":1410.24,"gross_charge":1469,"discounted_cash":852.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1395.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1410.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1072.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1219.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1072.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":705.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":509.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":470.08,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-DRAIN HAND TENDON SH","code_information":[{"code":"3497510415","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":309.76,"maximum":929.28,"gross_charge":968,"discounted_cash":561.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":919.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":929.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":706.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":803.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":706.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":464.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":335.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":309.76,"methodology":"fee schedule"}]}]},{"description":"PHYS CHGS-EXP/TRT FINGER JOINT","code_information":[{"code":"3497510420","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":275.84,"maximum":827.52,"gross_charge":862,"discounted_cash":499.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":818.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":827.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":629.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":715.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":629.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":413.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":298.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":275.84,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXC MLG LESION 2.1-3.","code_information":[{"code":"3497510425","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":268.16,"maximum":804.48,"gross_charge":838,"discounted_cash":486.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":796.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":804.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":611.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":695.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":611.74,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":402.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":290.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":268.16,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXC MLG LESION 3.1-4.","code_information":[{"code":"3497510430","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":281.92,"maximum":845.76,"gross_charge":881,"discounted_cash":510.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":836.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":845.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":643.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":731.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":643.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":422.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":305.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":281.92,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXPLORATORY BRST PROC","code_information":[{"code":"3497510435","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":352.96,"maximum":1058.88,"gross_charge":1103,"discounted_cash":639.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1047.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1058.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":805.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":915.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":805.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":529.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":382.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":352.96,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-LAP ING HERNIA RPR","code_information":[{"code":"3497510440","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":498.24,"maximum":1494.72,"gross_charge":1557,"discounted_cash":903.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1479.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1494.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1136.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1292.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1136.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":747.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":539.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":498.24,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-HEMORRHOIDECTOMY","code_information":[{"code":"3497510445","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":432,"maximum":1296,"gross_charge":1350,"discounted_cash":783,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1282.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1296,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":985.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1120.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":985.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":648,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":468.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":432,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-NEEDLE BIOPSY LIVER","code_information":[{"code":"3497510455","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":88,"maximum":264,"gross_charge":275,"discounted_cash":159.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":261.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":264,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":200.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":228.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":200.75,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":132,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":95.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":88,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-REMOVE GROIN LYMPH NO","code_information":[{"code":"3497510460","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":708.8,"maximum":2126.4,"gross_charge":2215,"discounted_cash":1284.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2104.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2126.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1616.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1838.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1616.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1063.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":768.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":708.8,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-REMOVE SUTURES W/ANES","code_information":[{"code":"3497510465","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":50.56,"maximum":151.68,"gross_charge":158,"discounted_cash":91.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":150.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":151.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":115.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":115.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":54.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":50.56,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXC BACK LESIONS","code_information":[{"code":"3497510470","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":417.28,"maximum":1251.84,"gross_charge":1304,"discounted_cash":756.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1238.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1251.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":951.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1082.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":951.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":625.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":452.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":417.28,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-I&D HEMATOMA","code_information":[{"code":"3497510475","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":143.04,"maximum":429.12,"gross_charge":447,"discounted_cash":259.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":424.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":429.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":326.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":371.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":326.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":214.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":155.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":143.04,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-STAB PHLEB VEINS10-2","code_information":[{"code":"3497510480","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":556.8,"maximum":1670.4,"gross_charge":1740,"discounted_cash":1009.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1653,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1670.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1270.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1444.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1270.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":835.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":603.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":556.8,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-SMPL RPR LAC 2.5CM/LE","code_information":[{"code":"3497510485","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":135.36,"maximum":406.08,"gross_charge":423,"discounted_cash":245.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":401.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":308.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":351.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":308.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":203.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":146.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":135.36,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-PARTIAL MASTECTOMY","code_information":[{"code":"3497510490","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":719.36,"maximum":2158.08,"gross_charge":2248,"discounted_cash":1303.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2135.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2158.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1641.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1865.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1641.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1079.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":779.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":719.36,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-LESION REMOVE COLONOS","code_information":[{"code":"3497510495","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":436.16,"maximum":1308.48,"gross_charge":1363,"discounted_cash":790.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1294.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1308.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":994.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1131.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":994.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":654.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":472.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":436.16,"methodology":"fee schedule"}]}]},{"description":"REM SKINTAG < OR =15 PF","code_information":[{"code":"3497510505","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":76.48,"maximum":229.44,"gross_charge":239,"discounted_cash":138.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":227.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":229.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":174.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":198.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":174.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":114.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":82.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":76.48,"methodology":"fee schedule"}]}]},{"description":"EXC SHOULDER LES SC>3 CM OR PF","code_information":[{"code":"3497510508","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":375.68,"maximum":1127.04,"gross_charge":1174,"discounted_cash":680.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1115.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1127.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":857.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":974.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":857.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":563.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":407.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":375.68,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-DESTRUCT LESIONFIRST","code_information":[{"code":"3497510510","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":63.36,"maximum":190.08,"gross_charge":198,"discounted_cash":114.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":188.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":190.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":164.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":95.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":68.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":63.36,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-LAP APPENDECTOMY","code_information":[{"code":"3497510515","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":527.04,"maximum":1581.12,"gross_charge":1647,"discounted_cash":955.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1564.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1581.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1202.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1367.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1202.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":790.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":571.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":527.04,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-PLACE GASTRO TUBE","code_information":[{"code":"3497510520","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":214.08,"maximum":642.24,"gross_charge":669,"discounted_cash":388.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":635.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":642.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":488.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":555.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":488.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":321.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":232.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":214.08,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-REMOVE ANAL TAG","code_information":[{"code":"3497510525","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":281.6,"maximum":844.8,"gross_charge":880,"discounted_cash":510.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":836,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":844.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":642.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":730.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":642.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":422.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":305.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":281.6,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-SM BOWEL ENDOSCOPY","code_information":[{"code":"3497510530","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":55.36,"maximum":166.08,"gross_charge":173,"discounted_cash":100.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":164.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":166.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":126.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":143.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":126.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":83.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":60,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":55.36,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG DEBRIDE TISSUE MUSCLE","code_information":[{"code":"3497510535","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":208.32,"maximum":624.96,"gross_charge":651,"discounted_cash":377.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":618.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":624.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":475.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":540.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":475.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":312.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":225.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":208.32,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG PARTIAL MASECTOMY","code_information":[{"code":"3497510540","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":543.04,"maximum":1629.12,"gross_charge":1697,"discounted_cash":984.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1612.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1629.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1238.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1408.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1238.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":814.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":588.52,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":543.04,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-SKIN TISSUE REARRANGE","code_information":[{"code":"3497510555","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":602.24,"maximum":1806.72,"gross_charge":1882,"discounted_cash":1091.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1787.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1806.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1373.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1562.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1373.86,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":903.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":652.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":602.24,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXC LESION","code_information":[{"code":"3497510560","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":137.28,"maximum":411.84,"gross_charge":429,"discounted_cash":248.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":407.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":411.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":313.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":356.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":313.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":205.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":148.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":137.28,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXC GANLN CYST","code_information":[{"code":"3497510565","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":333.44,"maximum":1000.32,"gross_charge":1042,"discounted_cash":604.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":989.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1000.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":760.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":864.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":760.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":500.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":361.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":333.44,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXC MALG LESION","code_information":[{"code":"3497510570","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":402.56,"maximum":1207.68,"gross_charge":1258,"discounted_cash":729.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1195.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1207.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":918.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1044.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":918.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":603.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":436.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":402.56,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT SCLP7.6-12.5CM PHY","code_information":[{"code":"3497510575","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":267.52,"maximum":802.56,"gross_charge":836,"discounted_cash":484.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":794.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":802.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":610.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":693.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":610.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":401.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":289.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":267.52,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-UNLISTED LAP PROC","code_information":[{"code":"3497510580","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":438.08,"maximum":1314.24,"gross_charge":1369,"discounted_cash":794.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1300.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1314.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":999.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1136.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":999.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":657.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":474.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":438.08,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-LAPAROSCOPY W/BIOPSY","code_information":[{"code":"3497510585","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":302.72,"maximum":908.16,"gross_charge":946,"discounted_cash":548.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":898.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":908.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":690.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":785.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":690.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":454.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":328.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":302.72,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXC MALIG LESION","code_information":[{"code":"3497510590","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":215.04,"maximum":645.12,"gross_charge":672,"discounted_cash":389.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":638.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":645.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":490.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":557.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":490.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":322.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":233.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":215.04,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXC FACIAL LESION","code_information":[{"code":"3497510595","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":175.68,"maximum":527.04,"gross_charge":549,"discounted_cash":318.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":521.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":527.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":400.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":455.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":400.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":263.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":190.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":175.68,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-EXC THIGH/KNEE TUMOR","code_information":[{"code":"3497510600","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":637.12,"maximum":1911.36,"gross_charge":1991,"discounted_cash":1154.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1891.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1911.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1453.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1652.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1453.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":955.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":690.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":637.12,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-ENDOVENOUS RF ADD-0N","code_information":[{"code":"3497510605","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":163.2,"maximum":489.6,"gross_charge":510,"discounted_cash":295.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":484.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":489.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":372.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":423.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":372.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":244.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":176.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":163.2,"methodology":"fee schedule"}]}]},{"description":"ENDOVEN THER CHEM ADHES 1ST OR","code_information":[{"code":"3497510606","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":1535.68,"maximum":4607.04,"gross_charge":4799,"discounted_cash":2783.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4559.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4607.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3503.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3983.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3503.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2303.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1664.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1535.68,"methodology":"fee schedule"}]}]},{"description":"ENDOVEN THER CHEM AD 1ST BI OR","code_information":[{"code":"3497510607","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":3071.36,"maximum":9214.08,"gross_charge":9598,"discounted_cash":5566.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":9118.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":9214.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":7006.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7966.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":7006.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4607.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3328.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3071.36,"methodology":"fee schedule"}]}]},{"description":"ENDOVEN THER CHEM AD SBSQ OR","code_information":[{"code":"3497510608","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":120.96,"maximum":362.88,"gross_charge":378,"discounted_cash":219.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":359.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":362.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":275.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":313.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":275.94,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":181.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":131.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":120.96,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-UPPER GI SCOPE","code_information":[{"code":"3497510610","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":100.48,"maximum":301.44,"gross_charge":314,"discounted_cash":182.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":298.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":301.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":229.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":260.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":229.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":150.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":108.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":100.48,"methodology":"fee schedule"}]}]},{"description":"PHYS CHG-INJ/SCLEROSING SOLU","code_information":[{"code":"3497510615","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":104.64,"maximum":313.92,"gross_charge":327,"discounted_cash":189.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":310.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":313.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":238.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":271.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":238.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":156.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":113.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":104.64,"methodology":"fee schedule"}]}]},{"description":"EXC BENIGN LESION 1.1-2.0 CM","code_information":[{"code":"3497510620","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":161.28,"maximum":483.84,"gross_charge":504,"discounted_cash":292.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":478.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":483.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":367.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":418.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":367.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":241.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":174.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":161.28,"methodology":"fee schedule"}]}]},{"description":"ABLATION EXTREM 1ST VEIN BI PF","code_information":[{"code":"3497510625","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":1859.2,"maximum":5577.6,"gross_charge":5810,"discounted_cash":3369.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5519.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5577.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4241.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4822.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4241.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2788.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2014.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1859.2,"methodology":"fee schedule"}]}]},{"description":"UGI NDSC RMVL TUMOR/POLYP/LES","code_information":[{"code":"3497510635","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":440.64,"maximum":1321.92,"gross_charge":1377,"discounted_cash":798.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1308.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1321.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1005.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1142.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1005.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":660.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":477.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":440.64,"methodology":"fee schedule"}]}]},{"description":"SCREEN COLON-NON HI RISK","code_information":[{"code":"3497510645","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":306.24,"maximum":918.72,"gross_charge":957,"discounted_cash":555.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":909.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":918.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":698.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":794.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":698.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":459.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":331.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":306.24,"methodology":"fee schedule"}]}]},{"description":"DILATION AND CURETTAGE","code_information":[{"code":"3497510655","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":266.24,"maximum":798.72,"gross_charge":832,"discounted_cash":482.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":790.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":798.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":607.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":690.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":607.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":399.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":288.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":266.24,"methodology":"fee schedule"}]}]},{"description":"FLEX SIG SCREENING","code_information":[{"code":"3497510660","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":144.64,"maximum":433.92,"gross_charge":452,"discounted_cash":262.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":429.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":433.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":329.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":375.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":329.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":216.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":156.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":144.64,"methodology":"fee schedule"}]}]},{"description":"REPOSITN GASTROSTOMY TB SUR PF","code_information":[{"code":"3497510675","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":142.08,"maximum":426.24,"gross_charge":444,"discounted_cash":257.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":421.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":426.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":324.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":368.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":324.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":213.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":153.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"}]}]},{"description":"REEXPLORE PELVIC WOUND OR","code_information":[{"code":"3497510700","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":308.8,"maximum":926.4,"gross_charge":965,"discounted_cash":559.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":916.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":926.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":704.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":800.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":704.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":463.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":334.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":308.8,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR AA HRN 1ST<3CM RDC","code_information":[{"code":"3497511200","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":294.08,"maximum":882.24,"gross_charge":919,"discounted_cash":533.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":873.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":882.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":670.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":762.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":670.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":441.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":318.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":294.08,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR AAHRN1ST<3NCR/STRN","code_information":[{"code":"3497511201","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":407.68,"maximum":1223.04,"gross_charge":1274,"discounted_cash":738.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1210.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1223.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":930.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1057.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":930.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":611.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":441.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":407.68,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR AA HRN 1ST3-10 RDC","code_information":[{"code":"3497511202","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":490.88,"maximum":1472.64,"gross_charge":1534,"discounted_cash":889.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1457.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1472.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1119.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1273.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1119.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":736.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":532,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":490.88,"methodology":"fee schedule"}]}]},{"description":"PHYCHG-RPRAAHRN1ST3-10NCR/STRN","code_information":[{"code":"3497511203","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":637.76,"maximum":1913.28,"gross_charge":1993,"discounted_cash":1155.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1893.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1913.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1454.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1654.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1454.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":956.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":691.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":637.76,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR AA HRN 1ST >10 RDC","code_information":[{"code":"3497511204","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":661.76,"maximum":1985.28,"gross_charge":2068,"discounted_cash":1199.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1964.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1985.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1509.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1716.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1509.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":992.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":717.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":661.76,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPRAAHRN1ST>10NCR/STRN","code_information":[{"code":"3497511205","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":447.36,"maximum":1342.08,"gross_charge":1398,"discounted_cash":810.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1328.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1342.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1020.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1160.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1020.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":671.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":484.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":447.36,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR UMB LESION WPRICLS","code_information":[{"code":"3497511206","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":326.08,"maximum":978.24,"gross_charge":1019,"discounted_cash":591.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":968.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":978.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":743.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":845.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":743.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":489.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":353.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":326.08,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR UMBLES W/WO PROSTH","code_information":[{"code":"3497511207","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":2137.28,"maximum":6411.84,"gross_charge":6679,"discounted_cash":3873.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6345.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6411.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4875.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5543.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4875.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3205.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2316.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2137.28,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR UMB LES WRMVPROSTH","code_information":[{"code":"3497511208","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":499.2,"maximum":1497.6,"gross_charge":1560,"discounted_cash":904.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1482,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1497.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1138.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1294.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1138.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":748.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":541.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":499.2,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR UMB LESION 1ST STG","code_information":[{"code":"3497511209","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":308.16,"maximum":924.48,"gross_charge":963,"discounted_cash":558.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":914.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":924.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":702.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":799.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":702.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":462.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":333.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":308.16,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR UMB LESION 2ND STG","code_information":[{"code":"3497511210","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":272,"maximum":816,"gross_charge":850,"discounted_cash":493,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":807.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":816,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":620.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":705.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":620.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":408,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":294.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":272,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR AA HRN RCR<3 RDC","code_information":[{"code":"3497511211","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":361.92,"maximum":1085.76,"gross_charge":1131,"discounted_cash":655.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1074.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1085.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":825.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":938.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":825.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":542.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":392.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":361.92,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPRAAHRN RCR<3NCR/STRN","code_information":[{"code":"3497511212","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":489.6,"maximum":1468.8,"gross_charge":1530,"discounted_cash":887.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1453.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1468.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1116.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1269.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1116.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":734.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":530.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":489.6,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR AA HRNRCR 3-10 RDC","code_information":[{"code":"3497511213","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":279.68,"maximum":839.04,"gross_charge":874,"discounted_cash":506.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":830.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":839.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":638.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":725.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":638.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":419.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":303.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":279.68,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPRAAHRNRCR3-10NCR/STR","code_information":[{"code":"3497511214","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":733.76,"maximum":2201.28,"gross_charge":2293,"discounted_cash":1329.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2178.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2201.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1673.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1903.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1673.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1100.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":795.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":733.76,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPR AA HRN RCR >10 RDC","code_information":[{"code":"3497511215","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":387.2,"maximum":1161.6,"gross_charge":1210,"discounted_cash":701.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1149.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1161.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":883.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1004.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":883.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":580.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":419.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":387.2,"methodology":"fee schedule"}]}]},{"description":"PHY CHG-RPRAAHRNRCR>10NCR/STRN","code_information":[{"code":"3497511216","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":541.76,"maximum":1625.28,"gross_charge":1693,"discounted_cash":981.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1608.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1625.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1235.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1405.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1235.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":812.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":587.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":541.76,"methodology":"fee schedule"}]}]},{"description":"EXAM VAGINA W SCOPE CLI OR","code_information":[{"code":"3497511217","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":119.36,"maximum":358.08,"gross_charge":373,"discounted_cash":216.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":354.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":358.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":272.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":309.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":272.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":179.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":129.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":119.36,"methodology":"fee schedule"}]}]},{"description":"CLSD TX NASAL FX W/STAB CLI OR","code_information":[{"code":"3497511218","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":200.32,"maximum":600.96,"gross_charge":626,"discounted_cash":363.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":594.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":600.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":456.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":519.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":456.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":300.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":217.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":200.32,"methodology":"fee schedule"}]}]},{"description":"RECONSTR OF NOSE COMPL CLI OR","code_information":[{"code":"3497511220","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":1270.08,"maximum":3810.24,"gross_charge":3969,"discounted_cash":2302.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3770.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3810.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2897.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3294.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2897.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1905.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1376.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1270.08,"methodology":"fee schedule"}]}]},{"description":"RECONSNOSE W/MAJ SEPTAL CLI","code_information":[{"code":"3497511221","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":1295.36,"maximum":3886.08,"gross_charge":4048,"discounted_cash":2347.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3845.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3886.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2955.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3359.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2955.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1943.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1403.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1295.36,"methodology":"fee schedule"}]}]},{"description":"REVISION OF NOSE CLI OR","code_information":[{"code":"3497511222","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":1565.12,"maximum":4695.36,"gross_charge":4891,"discounted_cash":2836.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4646.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4695.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3570.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4059.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3570.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2347.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1696.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1565.12,"methodology":"fee schedule"}]}]},{"description":"REPAIR NASAL STENOSIS CLI OR","code_information":[{"code":"3497511223","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":919.36,"maximum":2758.08,"gross_charge":2873,"discounted_cash":1666.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2729.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2758.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2097.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2384.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2097.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1379.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":996.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":919.36,"methodology":"fee schedule"}]}]},{"description":"REPAIR OF NASAL SEPTUM CLI OR","code_information":[{"code":"3497511224","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":607.68,"maximum":1823.04,"gross_charge":1899,"discounted_cash":1101.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1804.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1823.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1386.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1576.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1386.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":911.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":658.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":607.68,"methodology":"fee schedule"}]}]},{"description":"NASAL/SINUS ENDO RESECT CLI OR","code_information":[{"code":"3497511225","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":141.12,"maximum":423.36,"gross_charge":441,"discounted_cash":255.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":418.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":423.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":321.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":366.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":321.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":211.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":152.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":141.12,"methodology":"fee schedule"}]}]},{"description":"REM TONSIL & ADEN <AGE 12 CLI","code_information":[{"code":"3497511226","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":264,"maximum":792,"gross_charge":825,"discounted_cash":478.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":783.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":792,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":602.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":684.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":602.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":396,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":286.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":264,"methodology":"fee schedule"}]}]},{"description":"REM TONSIL & ADEN AGE 12/>CLI","code_information":[{"code":"3497511227","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":275.52,"maximum":826.56,"gross_charge":861,"discounted_cash":499.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":817.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":826.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":628.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":714.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":628.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":413.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":298.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":275.52,"methodology":"fee schedule"}]}]},{"description":"REM TONSILS <AGE 12 CLI OR","code_information":[{"code":"3497511228","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":245.76,"maximum":737.28,"gross_charge":768,"discounted_cash":445.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":729.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":737.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":560.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":637.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":560.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":368.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":266.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":245.76,"methodology":"fee schedule"}]}]},{"description":"REM ADENOIDS <AGE 12 CLI OR","code_information":[{"code":"3497511230","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":195.2,"maximum":585.6,"gross_charge":610,"discounted_cash":353.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":579.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":585.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":445.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":506.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":445.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":292.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":211.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":195.2,"methodology":"fee schedule"}]}]},{"description":"AMPUTATION FINGER/THUMB CLI OR","code_information":[{"code":"3497511231","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":642.88,"maximum":1928.64,"gross_charge":2009,"discounted_cash":1165.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1908.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1928.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1466.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1667.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1466.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":964.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":696.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":642.88,"methodology":"fee schedule"}]}]},{"description":"EXC NECK TUM DEEP <5 CM CLI OR","code_information":[{"code":"3497511232","type":"CDM"},{"code":"0975","type":"RC"}],"standard_charges":[{"minimum":473.92,"maximum":1421.76,"gross_charge":1481,"discounted_cash":858.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1406.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1421.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1081.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1229.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1081.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":710.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":513.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":473.92,"methodology":"fee schedule"}]}]},{"description":"EVALUATIN OF WHEEZING PF","code_information":[{"code":"3497610001","type":"CDM"},{"code":"0976","type":"RC"}],"standard_charges":[{"minimum":35.84,"maximum":107.52,"gross_charge":112,"discounted_cash":64.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":106.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":107.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":81.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":92.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":81.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":53.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":38.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":35.84,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP SCALP 2.6- ER PF","code_information":[{"code":"3498100001","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":144.64,"maximum":433.92,"gross_charge":452,"discounted_cash":262.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":429.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":433.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":329.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":375.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":329.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":216.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":156.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":144.64,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP FACE <2.5CM ER PF","code_information":[{"code":"3498100002","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":143.04,"maximum":429.12,"gross_charge":447,"discounted_cash":259.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":424.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":429.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":326.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":371.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":326.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":214.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":155.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":143.04,"methodology":"fee schedule"}]}]},{"description":"I&D ABSCESS SIMPLE ER PF","code_information":[{"code":"3498100003","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":94.72,"maximum":284.16,"gross_charge":296,"discounted_cash":171.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":281.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":284.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":216.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":245.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":216.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":102.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":94.72,"methodology":"fee schedule"}]}]},{"description":"EXPL PENTR WOUND EXTREM ER PF","code_information":[{"code":"3498100004","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":512.64,"maximum":1537.92,"gross_charge":1602,"discounted_cash":929.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1521.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1537.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1169.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1329.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1169.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":768.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":555.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":512.64,"methodology":"fee schedule"}]}]},{"description":"INCISION/REM FB SIMPLE ER PF","code_information":[{"code":"3498100005","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":124.48,"maximum":373.44,"gross_charge":389,"discounted_cash":225.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":369.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":373.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":283.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":322.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":283.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":186.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":134.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":124.48,"methodology":"fee schedule"}]}]},{"description":"ASP ABSC HEMA CYST BULLA ER PF","code_information":[{"code":"3498100006","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":108.48,"maximum":325.44,"gross_charge":339,"discounted_cash":196.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":322.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":325.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":247.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":281.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":247.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":162.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":117.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":108.48,"methodology":"fee schedule"}]}]},{"description":"ARTHROCENT ASP/INJ JT SM ER PF","code_information":[{"code":"3498100009","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":51.84,"maximum":155.52,"gross_charge":162,"discounted_cash":93.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":153.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":155.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":118.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":134.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":118.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":56.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":51.84,"methodology":"fee schedule"}]}]},{"description":"EVAC HEMATOMA SUBUNGAL ER PF","code_information":[{"code":"3498100011","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":38.08,"maximum":114.24,"gross_charge":119,"discounted_cash":69.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":113.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":114.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":86.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":98.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":86.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":57.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":41.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":38.08,"methodology":"fee schedule"}]}]},{"description":"CNTRL NOSEBLEED ANT SMP ER PF","code_information":[{"code":"3498100012","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":95.04,"maximum":285.12,"gross_charge":297,"discounted_cash":172.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":282.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":285.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":216.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":246.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":216.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":142.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":103,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":95.04,"methodology":"fee schedule"}]}]},{"description":"EXC LES B TRNK AR 1.1-2. ER PF","code_information":[{"code":"3498100014","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":137.28,"maximum":411.84,"gross_charge":429,"discounted_cash":248.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":407.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":411.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":313.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":356.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":313.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":205.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":148.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":137.28,"methodology":"fee schedule"}]}]},{"description":"EXC LES B TRNK AR 2.1-3. ER PF","code_information":[{"code":"3498100015","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":173.12,"maximum":519.36,"gross_charge":541,"discounted_cash":313.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":513.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":519.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":394.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":449.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":394.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":259.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":187.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":173.12,"methodology":"fee schedule"}]}]},{"description":"EXC LESN B FACE <0.5C ER PF","code_information":[{"code":"3498100016","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":117.12,"maximum":351.36,"gross_charge":366,"discounted_cash":212.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":347.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":351.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":267.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":303.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":267.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":175.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":126.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":117.12,"methodology":"fee schedule"}]}]},{"description":"EXC LESN B FACE 1.1-2 ER PF","code_information":[{"code":"3498100017","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":175.68,"maximum":527.04,"gross_charge":549,"discounted_cash":318.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":521.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":527.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":400.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":455.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":400.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":263.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":190.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":175.68,"methodology":"fee schedule"}]}]},{"description":"AVULSION NAIL PLATE SGL ER PF","code_information":[{"code":"3498100019","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":84.8,"maximum":254.4,"gross_charge":265,"discounted_cash":153.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":251.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":254.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":193.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":219.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":193.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":127.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":91.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":84.8,"methodology":"fee schedule"}]}]},{"description":"EXC NAIL & MATRIX ER PF","code_information":[{"code":"3498100022","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":179.2,"maximum":537.6,"gross_charge":560,"discounted_cash":324.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":532,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":537.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":408.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":464.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":408.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":268.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":194.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":179.2,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP SCLP <2.5 CM ER PF","code_information":[{"code":"3498100024","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":135.36,"maximum":406.08,"gross_charge":423,"discounted_cash":245.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":401.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":308.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":351.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":308.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":203.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":146.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":135.36,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP SCLP 12.6- ER PF","code_information":[{"code":"3498100028","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":211.52,"maximum":634.56,"gross_charge":661,"discounted_cash":383.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":627.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":634.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":482.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":548.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":482.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":317.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":229.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":211.52,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP FC 2.6-5. ER PF","code_information":[{"code":"3498100031","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":157.44,"maximum":472.32,"gross_charge":492,"discounted_cash":285.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":467.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":472.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":359.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":408.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":359.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":236.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":170.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":157.44,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP FC 5.1-7. ER PF","code_information":[{"code":"3498100032","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":185.92,"maximum":557.76,"gross_charge":581,"discounted_cash":336.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":551.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":557.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":424.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":482.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":424.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":278.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":201.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":185.92,"methodology":"fee schedule"}]}]},{"description":"CLSR WOUND DEHISC SMP ER PF","code_information":[{"code":"3498100035","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":241.6,"maximum":724.8,"gross_charge":755,"discounted_cash":437.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":717.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":724.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":551.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":626.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":551.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":362.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":261.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":241.6,"methodology":"fee schedule"}]}]},{"description":"RPR LAC IN SCLP AXIL<2.5C ERPF","code_information":[{"code":"3498100037","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":180.48,"maximum":541.44,"gross_charge":564,"discounted_cash":327.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":535.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":541.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":411.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":468.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":411.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":270.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":195.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":180.48,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT SCLP AX 2.6- ER PF","code_information":[{"code":"3498100038","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":267.84,"maximum":803.52,"gross_charge":837,"discounted_cash":485.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":795.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":803.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":611.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":694.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":611.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":401.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":290.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":267.84,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT SCLP AX7.6-12ER PF","code_information":[{"code":"3498100039","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":267.52,"maximum":802.56,"gross_charge":836,"discounted_cash":484.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":794.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":802.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":610.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":693.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":610.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":401.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":289.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":267.52,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT SCALP 12.6 ER PF","code_information":[{"code":"3498100040","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":321.92,"maximum":965.76,"gross_charge":1006,"discounted_cash":583.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":955.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":965.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":734.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":834.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":734.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":482.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":348.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":321.92,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT NECK <2.5CM ER PF","code_information":[{"code":"3498100042","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":194.56,"maximum":583.68,"gross_charge":608,"discounted_cash":352.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":577.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":583.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":443.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":504.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":443.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":291.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":210.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":194.56,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT NECK 2.6- ER PF","code_information":[{"code":"3498100043","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":255.04,"maximum":765.12,"gross_charge":797,"discounted_cash":462.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":757.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":765.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":581.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":661.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":581.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":382.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":276.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":255.04,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT FACE <2.5CM ER PF","code_information":[{"code":"3498100045","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":219.84,"maximum":659.52,"gross_charge":687,"discounted_cash":398.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":652.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":659.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":501.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":570.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":501.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":329.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":238.26,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":219.84,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT FCE 2.6-5.CM ER PF","code_information":[{"code":"3498100046","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":237.12,"maximum":711.36,"gross_charge":741,"discounted_cash":429.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":703.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":711.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":540.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":615.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":540.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":355.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":256.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":237.12,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT FACE 5.1-7.5 ER PF","code_information":[{"code":"3498100047","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":255.36,"maximum":766.08,"gross_charge":798,"discounted_cash":462.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":758.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":766.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":582.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":662.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":582.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":383.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":276.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":255.36,"methodology":"fee schedule"}]}]},{"description":"LEVEL 1 ER PF","code_information":[{"code":"3498100049","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":21.12,"maximum":63.36,"gross_charge":66,"discounted_cash":38.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":62.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":63.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":48.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":54.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":48.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":31.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":22.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":21.12,"methodology":"fee schedule"}]}]},{"description":"LEVEL 2 ER PF","code_information":[{"code":"3498100050","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":39.36,"maximum":118.08,"gross_charge":123,"discounted_cash":71.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":116.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":118.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":89.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":102.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":89.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":42.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":39.36,"methodology":"fee schedule"}]}]},{"description":"LEVEL 3 ER PF","code_information":[{"code":"3498100051","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":61.44,"maximum":184.32,"gross_charge":192,"discounted_cash":111.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":182.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":184.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":140.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":159.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":92.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":66.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":61.44,"methodology":"fee schedule"}]}]},{"description":"LEVEL 4 ER PF","code_information":[{"code":"3498100052","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":114.24,"maximum":342.72,"gross_charge":357,"discounted_cash":207.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":339.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":342.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":260.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":296.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":260.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":171.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":123.81,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":114.24,"methodology":"fee schedule"}]}]},{"description":"RPR LAC CPLX SCALP 2.6 - ER PF","code_information":[{"code":"3498100055","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":352.96,"maximum":1058.88,"gross_charge":1103,"discounted_cash":639.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1047.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1058.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":805.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":915.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":805.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":529.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":382.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":352.96,"methodology":"fee schedule"}]}]},{"description":"TX FX CLAVICLE WO MANIP ER PF","code_information":[{"code":"3498100058","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":187.2,"maximum":561.6,"gross_charge":585,"discounted_cash":339.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":555.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":561.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":427.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":485.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":427.05,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":280.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":202.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":187.2,"methodology":"fee schedule"}]}]},{"description":"TX DISL SHLDR W MAN CLSD ER PF","code_information":[{"code":"3498100060","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":263.68,"maximum":791.04,"gross_charge":824,"discounted_cash":477.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":782.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":791.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":601.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":683.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":601.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":395.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":285.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":263.68,"methodology":"fee schedule"}]}]},{"description":"REM FB CONJUNCT SUPERFIC ER PF","code_information":[{"code":"3498100065","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":50.56,"maximum":151.68,"gross_charge":158,"discounted_cash":91.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":150.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":151.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":115.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":115.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":54.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":50.56,"methodology":"fee schedule"}]}]},{"description":"DEBR BRN <5% TTL SM ER PF","code_information":[{"code":"3498100069","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":76.8,"maximum":230.4,"gross_charge":240,"discounted_cash":139.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":228,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":230.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":175.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":199.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":175.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":115.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":83.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":76.8,"methodology":"fee schedule"}]}]},{"description":"DRESS/DEB BURN 5-10% MED ER PF","code_information":[{"code":"3498100070","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":135.68,"maximum":407.04,"gross_charge":424,"discounted_cash":245.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":402.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":407.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":309.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":351.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":309.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":203.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":147.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":135.68,"methodology":"fee schedule"}]}]},{"description":"DRESS/DEBRD BURN >10% LG ER PF","code_information":[{"code":"3498100071","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":158.72,"maximum":476.16,"gross_charge":496,"discounted_cash":287.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":471.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":476.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":362.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":411.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":362.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":238.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":172.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":158.72,"methodology":"fee schedule"}]}]},{"description":"INC HEMORRHOID EXTERNAL ER PF","code_information":[{"code":"3498100072","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":146.56,"maximum":439.68,"gross_charge":458,"discounted_cash":265.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":435.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":439.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":334.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":380.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":334.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":219.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":158.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":146.56,"methodology":"fee schedule"}]}]},{"description":"I&D ABS GLAND BARTHOLINS ER PF","code_information":[{"code":"3498100073","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":130.88,"maximum":392.64,"gross_charge":409,"discounted_cash":237.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":388.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":392.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":298.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":339.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":298.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":196.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":141.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":130.88,"methodology":"fee schedule"}]}]},{"description":"TX DIS (I-P) HND WO ANE ER PF","code_information":[{"code":"3498100080","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":236.8,"maximum":710.4,"gross_charge":740,"discounted_cash":429.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":703,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":710.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":540.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":614.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":540.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":355.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":256.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":236.8,"methodology":"fee schedule"}]}]},{"description":"TX DISL (I-P) HND W ANE ER PF","code_information":[{"code":"3498100081","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":332.48,"maximum":997.44,"gross_charge":1039,"discounted_cash":602.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":987.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":997.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":758.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":862.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":758.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":498.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":360.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":332.48,"methodology":"fee schedule"}]}]},{"description":"TX DISL PAT WO ANES CL ER PF","code_information":[{"code":"3498100083","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":317.12,"maximum":951.36,"gross_charge":991,"discounted_cash":574.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":941.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":951.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":723.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":822.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":723.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":475.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":343.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":317.12,"methodology":"fee schedule"}]}]},{"description":"TX FX FIB DIS W/O MAN CL ER PF","code_information":[{"code":"3498100087","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":276.16,"maximum":828.48,"gross_charge":863,"discounted_cash":500.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":819.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":828.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":629.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":716.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":629.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":414.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":299.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":276.16,"methodology":"fee schedule"}]}]},{"description":"TX FX METATARS WO MAN ER PF","code_information":[{"code":"3498100089","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":191.36,"maximum":574.08,"gross_charge":598,"discounted_cash":346.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":568.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":574.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":436.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":496.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":436.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":287.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":207.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":191.36,"methodology":"fee schedule"}]}]},{"description":"APPLICAT CAST ARM SHORT ER PF","code_information":[{"code":"3498100094","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":77.76,"maximum":233.28,"gross_charge":243,"discounted_cash":140.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":230.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":233.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":177.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":201.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":177.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":116.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":84.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":77.76,"methodology":"fee schedule"}]}]},{"description":"APPLICAT SPLINT ARM LNG ER PF","code_information":[{"code":"3498100096","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":78.08,"maximum":234.24,"gross_charge":244,"discounted_cash":141.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":231.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":234.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":178.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":202.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":178.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":117.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":84.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":78.08,"methodology":"fee schedule"}]}]},{"description":"APPL SPLNT ARM SHRT STAT ER PF","code_information":[{"code":"3498100097","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":61.12,"maximum":183.36,"gross_charge":191,"discounted_cash":110.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":181.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":183.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":139.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":158.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":139.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":91.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":66.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":61.12,"methodology":"fee schedule"}]}]},{"description":"REM FB CANAL AUD WO ER PF","code_information":[{"code":"3498100099","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":113.28,"maximum":339.84,"gross_charge":354,"discounted_cash":205.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":336.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":339.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":258.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":293.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":258.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":169.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":122.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":113.28,"methodology":"fee schedule"}]}]},{"description":"REMOVAL CERUMEN IMPACTED ER PF","code_information":[{"code":"3498100100","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":46.08,"maximum":138.24,"gross_charge":144,"discounted_cash":83.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":136.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":138.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":105.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":119.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":105.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":69.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":49.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":46.08,"methodology":"fee schedule"}]}]},{"description":"STRAPPING SHOULDR (VELP) ER PF","code_information":[{"code":"3498100101","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":57.92,"maximum":173.76,"gross_charge":181,"discounted_cash":104.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":171.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":173.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":150.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":132.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":62.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":57.92,"methodology":"fee schedule"}]}]},{"description":"STRAPPING ELBOW/WRIST ER PF","code_information":[{"code":"3498100102","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":49.28,"maximum":147.84,"gross_charge":154,"discounted_cash":89.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":146.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":147.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":112.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":127.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":112.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":53.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":49.28,"methodology":"fee schedule"}]}]},{"description":"LEVEL 5 ER PF","code_information":[{"code":"3498100108","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":168.96,"maximum":506.88,"gross_charge":528,"discounted_cash":306.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":501.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":506.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":385.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":438.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":385.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":253.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":183.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":168.96,"methodology":"fee schedule"}]}]},{"description":"APPL CAST LEG LONG ER PF","code_information":[{"code":"3498100109","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":121.6,"maximum":364.8,"gross_charge":380,"discounted_cash":220.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":361,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":364.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":277.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":315.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":277.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":182.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":131.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":121.6,"methodology":"fee schedule"}]}]},{"description":"APPL CAST LEG SHORT ER PF","code_information":[{"code":"3498100110","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":80.64,"maximum":241.92,"gross_charge":252,"discounted_cash":146.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":239.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":241.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":183.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":209.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":183.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":120.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":87.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":80.64,"methodology":"fee schedule"}]}]},{"description":"APPL CAST LEG SHORT WALK ER PF","code_information":[{"code":"3498100111","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":86.72,"maximum":260.16,"gross_charge":271,"discounted_cash":157.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":257.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":260.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":197.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":224.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":197.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":130.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":93.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":86.72,"methodology":"fee schedule"}]}]},{"description":"APPL SPLINT LEG SHORT ER PF","code_information":[{"code":"3498100113","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":63.04,"maximum":189.12,"gross_charge":197,"discounted_cash":114.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":187.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":189.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":143.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":143.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":94.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":68.32,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":63.04,"methodology":"fee schedule"}]}]},{"description":"REM/BIV CAST BODY ER PF","code_information":[{"code":"3498100117","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":56.64,"maximum":169.92,"gross_charge":177,"discounted_cash":102.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":168.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":169.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":129.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":146.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":129.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":84.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":61.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":56.64,"methodology":"fee schedule"}]}]},{"description":"CRIT CARE 30-74 MIN ER PF","code_information":[{"code":"3498100119","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":257.28,"maximum":771.84,"gross_charge":804,"discounted_cash":466.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":763.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":771.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":586.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":667.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":586.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":385.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":278.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":257.28,"methodology":"fee schedule"}]}]},{"description":"CRITICAL CARE ADDL 30MIN ER PF","code_information":[{"code":"3498100120","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":115.52,"maximum":346.56,"gross_charge":361,"discounted_cash":209.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":342.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":346.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":299.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":173.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":125.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":115.52,"methodology":"fee schedule"}]}]},{"description":"PROLONG SERV B/A PT CARE ER PF","code_information":[{"code":"3498100125","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":85.12,"maximum":255.36,"gross_charge":266,"discounted_cash":154.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":252.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":255.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":194.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":220.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":194.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":127.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":92.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":85.12,"methodology":"fee schedule"}]}]},{"description":"PROLONG SERV B/A PT CARE ER PF","code_information":[{"code":"3498100126","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":42.56,"maximum":127.68,"gross_charge":133,"discounted_cash":77.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":126.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":127.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":97.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":110.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":97.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":63.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":46.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":42.56,"methodology":"fee schedule"}]}]},{"description":"CATH BLADDER SMP ER PF","code_information":[{"code":"3498100127","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":88.64,"maximum":265.92,"gross_charge":277,"discounted_cash":160.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":263.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":265.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":202.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":229.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":202.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":132.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":96.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":88.64,"methodology":"fee schedule"}]}]},{"description":"ARTHEOCNT ASP/INJ JT MAJ ER PF","code_information":[{"code":"3498100128","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":74.24,"maximum":222.72,"gross_charge":232,"discounted_cash":134.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":220.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":222.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":169.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":192.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":169.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":111.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":80.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":74.24,"methodology":"fee schedule"}]}]},{"description":"RPR LC SMP SCLP 7.6-12.5 ER PF","code_information":[{"code":"3498100129","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":169.28,"maximum":507.84,"gross_charge":529,"discounted_cash":306.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":502.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":507.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":386.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":439.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":386.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":253.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":183.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":169.28,"methodology":"fee schedule"}]}]},{"description":"RPR LAC CPLX FOREHD 2.6-ER PF","code_information":[{"code":"3498100130","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":469.76,"maximum":1409.28,"gross_charge":1468,"discounted_cash":851.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1394.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1409.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1071.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1218.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1071.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":704.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":509.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":469.76,"methodology":"fee schedule"}]}]},{"description":"RPR LAC CPLX FOREHD 5CM ER PF","code_information":[{"code":"3498100131","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":147.52,"maximum":442.56,"gross_charge":461,"discounted_cash":267.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":437.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":442.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":336.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":382.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":336.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":221.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":159.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":147.52,"methodology":"fee schedule"}]}]},{"description":"TX FX TIB PRX WO MAN CL ER PF","code_information":[{"code":"3498100132","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":349.44,"maximum":1048.32,"gross_charge":1092,"discounted_cash":633.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1037.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1048.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":797.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":906.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":797.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":524.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":378.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":349.44,"methodology":"fee schedule"}]}]},{"description":"APPLCATION SPLNT LEG LNG ER PF","code_information":[{"code":"3498100133","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":69.12,"maximum":207.36,"gross_charge":216,"discounted_cash":125.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":205.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":207.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":157.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":179.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":157.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":74.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":69.12,"methodology":"fee schedule"}]}]},{"description":"INTRO HEMOST AGNT/PCK ER PF","code_information":[{"code":"3498100135","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":136.96,"maximum":410.88,"gross_charge":428,"discounted_cash":248.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":406.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":410.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":312.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":355.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":312.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":205.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":148.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":136.96,"methodology":"fee schedule"}]}]},{"description":"CPR ER PF","code_information":[{"code":"3498100136","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":286.72,"maximum":860.16,"gross_charge":896,"discounted_cash":519.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":851.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":860.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":654.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":743.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":654.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":430.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":310.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":286.72,"methodology":"fee schedule"}]}]},{"description":"INTUBATION ENDOTRACHEAL ER PF","code_information":[{"code":"3498100137","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":107.52,"maximum":322.56,"gross_charge":336,"discounted_cash":194.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":319.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":322.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":245.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":278.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":245.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":161.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":116.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":107.52,"methodology":"fee schedule"}]}]},{"description":"TX FX RAD/ULNA W MAN CLS ER PF","code_information":[{"code":"3498100138","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":507.52,"maximum":1522.56,"gross_charge":1586,"discounted_cash":919.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1506.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1522.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1157.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1316.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1157.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":761.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":550.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":507.52,"methodology":"fee schedule"}]}]},{"description":"TX FX HUMER PROX WO CL ER PF","code_information":[{"code":"3498100139","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":282.88,"maximum":848.64,"gross_charge":884,"discounted_cash":512.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":839.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":848.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":645.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":733.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":645.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":424.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":306.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":282.88,"methodology":"fee schedule"}]}]},{"description":"TX FX ULNAR STYLOID CLSD ER PF","code_information":[{"code":"3498100141","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":276.8,"maximum":830.4,"gross_charge":865,"discounted_cash":501.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":821.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":830.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":631.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":717.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":631.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":415.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":299.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":276.8,"methodology":"fee schedule"}]}]},{"description":"TX DISL SHLDR FX HUMR MN ER PF","code_information":[{"code":"3498100145","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":291.2,"maximum":873.6,"gross_charge":910,"discounted_cash":527.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":864.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":873.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":664.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":755.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":664.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":436.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":315.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":291.2,"methodology":"fee schedule"}]}]},{"description":"TX FX NASAL WO STABL ER PF","code_information":[{"code":"3498100147","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":205.76,"maximum":617.28,"gross_charge":643,"discounted_cash":372.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":610.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":617.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":469.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":533.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":469.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":308.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":223,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":205.76,"methodology":"fee schedule"}]}]},{"description":"TX FX RADIUS/ULNA WO ER PF","code_information":[{"code":"3498100148","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":183.04,"maximum":549.12,"gross_charge":572,"discounted_cash":331.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":543.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":549.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":417.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":474.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":417.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":274.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":198.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":183.04,"methodology":"fee schedule"}]}]},{"description":"THORACOSTMY W TUBE INSRT ER PF","code_information":[{"code":"3498100149","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":165.12,"maximum":495.36,"gross_charge":516,"discounted_cash":299.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":490.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":495.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":428.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":247.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":178.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":165.12,"methodology":"fee schedule"}]}]},{"description":"TX FX TIB SHAFT WO MAN ER PF","code_information":[{"code":"3498100150","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":301.44,"maximum":904.32,"gross_charge":942,"discounted_cash":546.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":894.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":904.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":687.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":781.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":687.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":452.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":326.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":301.44,"methodology":"fee schedule"}]}]},{"description":"TX FX PHAL WO MAN CLSD ER PF","code_information":[{"code":"3498100151","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":102.08,"maximum":306.24,"gross_charge":319,"discounted_cash":185.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":303.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":306.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":232.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":264.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":232.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":110.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":102.08,"methodology":"fee schedule"}]}]},{"description":"NASAL/ORO INSERT W STENT ER PF","code_information":[{"code":"3498100152","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":40,"maximum":120,"gross_charge":125,"discounted_cash":72.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":118.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":120,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":91.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":103.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":91.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":60,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":43.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":40,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP FACE 7.6- ER PF","code_information":[{"code":"3498100153","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":188.8,"maximum":566.4,"gross_charge":590,"discounted_cash":342.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":560.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":566.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":430.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":489.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":430.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":283.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":204.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":188.8,"methodology":"fee schedule"}]}]},{"description":"RPR LAC INT SCLP 20.1 ER PF","code_information":[{"code":"3498100154","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":364.16,"maximum":1092.48,"gross_charge":1138,"discounted_cash":660.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1081.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1092.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":830.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":944.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":830.74,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":546.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":394.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":364.16,"methodology":"fee schedule"}]}]},{"description":"TX DISL SHLDR W MAN/ANES ER PF","code_information":[{"code":"3498100155","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":337.92,"maximum":1013.76,"gross_charge":1056,"discounted_cash":612.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1003.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1013.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":770.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":876.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":770.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":506.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":366.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":337.92,"methodology":"fee schedule"}]}]},{"description":"CNTRL NOSEBLEED ANT CPLX ER PF","code_information":[{"code":"3498100156","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":160.32,"maximum":480.96,"gross_charge":501,"discounted_cash":290.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":475.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":480.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":365.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":415.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":365.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":240.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":173.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":160.32,"methodology":"fee schedule"}]}]},{"description":"DEBR/REM DEV TISS <20 ER PF","code_information":[{"code":"3498100157","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":65.92,"maximum":197.76,"gross_charge":206,"discounted_cash":119.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":195.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":197.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":170.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":71.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":65.92,"methodology":"fee schedule"}]}]},{"description":"CARDIOVERSION EXTERNA ER PF","code_information":[{"code":"3498100158","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":290.56,"maximum":871.68,"gross_charge":908,"discounted_cash":526.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":862.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":871.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":662.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":753.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":662.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":435.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":314.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":290.56,"methodology":"fee schedule"}]}]},{"description":"TX FX FEM PROX CLSD ER PF","code_information":[{"code":"3498100159","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":420.48,"maximum":1261.44,"gross_charge":1314,"discounted_cash":762.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1248.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1261.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":959.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1090.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":959.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":630.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":455.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":420.48,"methodology":"fee schedule"}]}]},{"description":"TX FX HUMER SHAFT CLS ER PF","code_information":[{"code":"3498100160","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":304.96,"maximum":914.88,"gross_charge":953,"discounted_cash":552.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":905.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":914.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":695.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":790.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":695.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":457.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":330.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":304.96,"methodology":"fee schedule"}]}]},{"description":"TX FX PHAL PROX WO MAN ER PF","code_information":[{"code":"3498100161","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":166.4,"maximum":499.2,"gross_charge":520,"discounted_cash":301.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":494,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":499.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":379.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":431.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":379.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":249.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":180.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":166.4,"methodology":"fee schedule"}]}]},{"description":"TX FX RADIAL HD/NCK CLSD ER PF","code_information":[{"code":"3498100162","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":198.08,"maximum":594.24,"gross_charge":619,"discounted_cash":359.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":588.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":594.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":451.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":513.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":451.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":297.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":214.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":198.08,"methodology":"fee schedule"}]}]},{"description":"STRAPPING ANKLE/FOOT ER PF","code_information":[{"code":"3498100163","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":31.68,"maximum":95.04,"gross_charge":99,"discounted_cash":57.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":94.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":95.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":72.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":82.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":72.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":34.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":31.68,"methodology":"fee schedule"}]}]},{"description":"PLACE NDL INFS INTRAOSSO ER PF","code_information":[{"code":"3498100164","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":64.32,"maximum":192.96,"gross_charge":201,"discounted_cash":116.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":190.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":192.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":146.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":166.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":146.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":96.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":69.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":64.32,"methodology":"fee schedule"}]}]},{"description":"TX FX BIMALLEO W MAN CLS ER PF","code_information":[{"code":"3498100165","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":342.08,"maximum":1026.24,"gross_charge":1069,"discounted_cash":620.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1015.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1026.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":780.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":887.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":780.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":513.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":370.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":342.08,"methodology":"fee schedule"}]}]},{"description":"ARTHROCNT ASP/INJ JT INT ER PF","code_information":[{"code":"3498100166","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":55.04,"maximum":165.12,"gross_charge":172,"discounted_cash":99.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":163.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":165.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":125.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":142.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":125.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":82.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":59.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":55.04,"methodology":"fee schedule"}]}]},{"description":"STRAPPING HAND/FINGER ER PF","code_information":[{"code":"3498100167","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":45.76,"maximum":137.28,"gross_charge":143,"discounted_cash":82.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":135.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":137.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":104.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":118.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":104.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":49.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":45.76,"methodology":"fee schedule"}]}]},{"description":"CNTRL NOSEBLEED ANT SMP ER PF","code_information":[{"code":"3498100168","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":190.08,"maximum":570.24,"gross_charge":594,"discounted_cash":344.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":564.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":570.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":433.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":493.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":433.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":285.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":206,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":190.08,"methodology":"fee schedule"}]}]},{"description":"TX FX PHAL DIST W MAN CL ER PF","code_information":[{"code":"3498100169","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":272.64,"maximum":817.92,"gross_charge":852,"discounted_cash":494.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":809.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":817.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":621.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":707.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":621.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":408.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":295.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":272.64,"methodology":"fee schedule"}]}]},{"description":"DRAIN ABS/CYS DENTOALVLR ER PF","code_information":[{"code":"3498100171","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":107.84,"maximum":323.52,"gross_charge":337,"discounted_cash":195.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":320.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":323.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":246.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":279.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":246.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":161.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":116.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":107.84,"methodology":"fee schedule"}]}]},{"description":"INJ TRIG PT 1-2 MUSCL(S) ER PF","code_information":[{"code":"3498100172","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":51.2,"maximum":153.6,"gross_charge":160,"discounted_cash":92.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":152,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":153.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":132.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":55.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":51.2,"methodology":"fee schedule"}]}]},{"description":"TX FX DISL SHLDR NCK W M ER PF","code_information":[{"code":"3498100175","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":560.96,"maximum":1682.88,"gross_charge":1753,"discounted_cash":1016.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1665.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1682.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1279.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1454.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1279.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":841.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":607.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":560.96,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP SCLP >30.0CM ER PF","code_information":[{"code":"3498100176","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":296.64,"maximum":889.92,"gross_charge":927,"discounted_cash":537.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":880.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":889.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":676.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":769.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":676.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":444.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":321.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":296.64,"methodology":"fee schedule"}]}]},{"description":"REM FB CORNL WO SLIT ER PF","code_information":[{"code":"3498100177","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":48,"maximum":144,"gross_charge":150,"discounted_cash":87,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":142.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":52.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":48,"methodology":"fee schedule"}]}]},{"description":"TX DIS ANK WO ANES ER PF","code_information":[{"code":"3498100178","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":261.76,"maximum":785.28,"gross_charge":818,"discounted_cash":474.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":777.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":785.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":597.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":678.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":597.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":392.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":283.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":261.76,"methodology":"fee schedule"}]}]},{"description":"I&D ABSC ISCH/PERIRECTAL ER PF","code_information":[{"code":"3498100199","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":386.88,"maximum":1160.64,"gross_charge":1209,"discounted_cash":701.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1148.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1160.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":882.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1003.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":882.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":580.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":419.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":386.88,"methodology":"fee schedule"}]}]},{"description":"RPR LAC SMP FC 20.1-3 ER PF","code_information":[{"code":"3498100200","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":132.16,"maximum":396.48,"gross_charge":413,"discounted_cash":239.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":392.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":396.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":301.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":342.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":301.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":198.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":143.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":132.16,"methodology":"fee schedule"}]}]},{"description":"TX DISL HIP TRAU W ANES ER PF","code_information":[{"code":"3498100201","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":500.8,"maximum":1502.4,"gross_charge":1565,"discounted_cash":907.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1486.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1502.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1142.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1298.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1142.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":751.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":542.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":500.8,"methodology":"fee schedule"}]}]},{"description":"TX RAD/ULNA SHFT W MAN CLSERPF","code_information":[{"code":"3498100202","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":432.96,"maximum":1298.88,"gross_charge":1353,"discounted_cash":784.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1285.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1298.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":987.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1122.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":987.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":649.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":469.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":432.96,"methodology":"fee schedule"}]}]},{"description":"REMOVE FB INTRANASAL ER PF","code_information":[{"code":"3498100203","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":108.8,"maximum":326.4,"gross_charge":340,"discounted_cash":197.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":323,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":326.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":248.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":282.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":248.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":163.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":117.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":108.8,"methodology":"fee schedule"}]}]},{"description":"TX DISL HIP TRAUM W ANES ER PF","code_information":[{"code":"3498100205","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":566.08,"maximum":1698.24,"gross_charge":1769,"discounted_cash":1026.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1680.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1698.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1291.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1468.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1291.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":849.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":613.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":566.08,"methodology":"fee schedule"}]}]},{"description":"REPAIR NAIL BED ER PF","code_information":[{"code":"3498100457","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":165.76,"maximum":497.28,"gross_charge":518,"discounted_cash":300.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":492.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":497.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":378.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":429.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":378.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":248.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":179.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":165.76,"methodology":"fee schedule"}]}]},{"description":"INS CATH CV NON-TUN>5YRS ERPF","code_information":[{"code":"3498101010","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":207.68,"maximum":623.04,"gross_charge":649,"discounted_cash":376.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":616.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":623.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":473.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":538.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":473.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":311.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":225.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":207.68,"methodology":"fee schedule"}]}]},{"description":"TX FX HUM PRX W MAN CLSD ER PF","code_information":[{"code":"3498110100","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":373.12,"maximum":1119.36,"gross_charge":1166,"discounted_cash":676.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1107.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1119.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":851.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":967.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":851.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":559.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":404.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":373.12,"methodology":"fee schedule"}]}]},{"description":"TX DISL ELB WO ANES CLSD ER PF","code_information":[{"code":"3498110103","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":311.36,"maximum":934.08,"gross_charge":973,"discounted_cash":564.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":924.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":934.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":710.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":807.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":710.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":467.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":337.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":311.36,"methodology":"fee schedule"}]}]},{"description":"TX DISL HIP TRAUM WO ANES ERPF","code_information":[{"code":"3498110106","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":187.84,"maximum":563.52,"gross_charge":587,"discounted_cash":340.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":557.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":563.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":428.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":487.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":428.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":281.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":203.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":187.84,"methodology":"fee schedule"}]}]},{"description":"TX FX METACAR W MAN CLSD ER PF","code_information":[{"code":"3498110109","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":279.04,"maximum":837.12,"gross_charge":872,"discounted_cash":505.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":828.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":837.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":636.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":723.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":636.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":418.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":302.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":279.04,"methodology":"fee schedule"}]}]},{"description":"DEB REM FB SKIN SUB MUSC ER PF","code_information":[{"code":"3498110110","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":618.88,"maximum":1856.64,"gross_charge":1934,"discounted_cash":1121.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1837.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1856.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1411.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1605.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1411.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":928.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":670.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":618.88,"methodology":"fee schedule"}]}]},{"description":"DESTRUCT LES PREMALG 1ST ER PF","code_information":[{"code":"3498110123","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":63.36,"maximum":190.08,"gross_charge":198,"discounted_cash":114.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":188.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":190.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":164.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":95.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":68.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":63.36,"methodology":"fee schedule"}]}]},{"description":"TX FX PATELL WO MAN CLS ER PF","code_information":[{"code":"3498110135","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":246.4,"maximum":739.2,"gross_charge":770,"discounted_cash":446.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":731.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":739.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":562.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":639.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":562.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":369.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":267.04,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":246.4,"methodology":"fee schedule"}]}]},{"description":"TX DIS KNEE WO ANES CLS ER PF","code_information":[{"code":"3498110140","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":423.68,"maximum":1271.04,"gross_charge":1324,"discounted_cash":767.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1257.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1271.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":966.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1098.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":966.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":635.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":459.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":423.68,"methodology":"fee schedule"}]}]},{"description":"TX FX GR TOE WO MAN CLS ER PF","code_information":[{"code":"3498110145","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":117.76,"maximum":353.28,"gross_charge":368,"discounted_cash":213.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":349.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":353.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":268.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":305.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":268.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":127.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":117.76,"methodology":"fee schedule"}]}]},{"description":"REM/BIV CAST ARM/LG FULL ER PF","code_information":[{"code":"3498110150","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":75.2,"maximum":225.6,"gross_charge":235,"discounted_cash":136.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":223.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":225.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":171.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":195.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":171.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":112.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":81.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":75.2,"methodology":"fee schedule"}]}]},{"description":"DRAIN ABS/CYST MOUTH SMP ER PF","code_information":[{"code":"3498110155","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":246.72,"maximum":740.16,"gross_charge":771,"discounted_cash":447.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":732.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":740.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":562.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":639.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":562.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":370.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":267.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":246.72,"methodology":"fee schedule"}]}]},{"description":"REMOVE FB PHARYNX ER PF","code_information":[{"code":"3498110160","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":233.28,"maximum":699.84,"gross_charge":729,"discounted_cash":422.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":692.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":699.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":532.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":605.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":532.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":349.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":252.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":233.28,"methodology":"fee schedule"}]}]},{"description":"BLADDER INSTILL AGENT ER PF","code_information":[{"code":"3498110165","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":97.6,"maximum":292.8,"gross_charge":305,"discounted_cash":176.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":289.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":292.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":222.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":253.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":222.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":146.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":105.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":97.6,"methodology":"fee schedule"}]}]},{"description":"COLPORRHAPHY NON-OB ER","code_information":[{"code":"3498110170","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":359.68,"maximum":1079.04,"gross_charge":1124,"discounted_cash":651.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1067.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1079.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":820.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":932.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":820.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":539.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":389.81,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":359.68,"methodology":"fee schedule"}]}]},{"description":"MOD SEDATION=>5Y 1ST 15M ER PF","code_information":[{"code":"3498110175","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":58.56,"maximum":175.68,"gross_charge":183,"discounted_cash":106.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":173.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":175.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":133.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":151.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":133.59,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":87.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":63.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":58.56,"methodology":"fee schedule"}]}]},{"description":"MOD SEDATION EA ADDL 15M ER PF","code_information":[{"code":"3498110180","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":41.92,"maximum":125.76,"gross_charge":131,"discounted_cash":75.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":124.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":125.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":95.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":108.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":95.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":45.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":41.92,"methodology":"fee schedule"}]}]},{"description":"MOD SED 1ST 15MINS <5YRS ER PF","code_information":[{"code":"3498110185","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":86.08,"maximum":258.24,"gross_charge":269,"discounted_cash":156.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":255.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":258.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":196.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":223.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":196.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":129.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":93.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":86.08,"methodology":"fee schedule"}]}]},{"description":"REM FB CORN W SLIT LMP ER PF","code_information":[{"code":"3498110190","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":78.4,"maximum":235.2,"gross_charge":245,"discounted_cash":142.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":232.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":235.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":178.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":203.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":178.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":117.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":84.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":78.4,"methodology":"fee schedule"}]}]},{"description":"INJ ANES NERVE PERIP BL ER PF","code_information":[{"code":"3498110195","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":79.68,"maximum":239.04,"gross_charge":249,"discounted_cash":144.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":236.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":239.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":206.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":119.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":86.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"}]}]},{"description":"INJ ANES NRV TRIGEMINAL ER PF","code_information":[{"code":"3498110203","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":174.08,"maximum":522.24,"gross_charge":544,"discounted_cash":315.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":516.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":522.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":397.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":451.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":397.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":261.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":188.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":174.08,"methodology":"fee schedule"}]}]},{"description":"TX FX GR TOE W MAN CLSD ER PF","code_information":[{"code":"3498110250","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":145.28,"maximum":435.84,"gross_charge":454,"discounted_cash":263.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":431.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":435.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":331.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":376.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":331.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":217.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":157.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":145.28,"methodology":"fee schedule"}]}]},{"description":"PUNCTURE ARTERIAL ER PF","code_information":[{"code":"3498110866","type":"CDM"},{"code":"0981","type":"RC"}],"standard_charges":[{"minimum":12.8,"maximum":38.4,"gross_charge":40,"discounted_cash":23.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":12.8,"methodology":"fee schedule"}]}]},{"description":"OBS ADMIT/DIS LVL2 CLI HOSP PF","code_information":[{"code":"3498200016","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":140.8,"maximum":422.4,"gross_charge":440,"discounted_cash":255.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":418,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":422.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":321.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":365.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":321.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":152.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":140.8,"methodology":"fee schedule"}]}]},{"description":"OBS ADMIT/DIS LVL 3CLI HOSP PF","code_information":[{"code":"3498200022","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":204.48,"maximum":613.44,"gross_charge":639,"discounted_cash":370.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":607.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":613.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":466.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":530.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":466.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":306.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":221.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":204.48,"methodology":"fee schedule"}]}]},{"description":"OBS ADMIT/DIS LVL1 CLI HOSP PF","code_information":[{"code":"3498200023","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":86.4,"maximum":259.2,"gross_charge":270,"discounted_cash":156.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":256.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":259.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":197.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":224.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":197.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":129.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":93.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":86.4,"methodology":"fee schedule"}]}]},{"description":"LWREXTVACSTD BI OP CLI PF HOSP","code_information":[{"code":"3498200048","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":174.72,"maximum":524.16,"gross_charge":546,"discounted_cash":316.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":518.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":524.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":398.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":453.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":398.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":262.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":189.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":174.72,"methodology":"fee schedule"}]}]},{"description":"ABD PARA W GUID OP CLI HOSP PF","code_information":[{"code":"3498200147","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":282.88,"maximum":848.64,"gross_charge":884,"discounted_cash":512.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":839.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":848.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":645.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":733.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":645.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":424.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":306.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":282.88,"methodology":"fee schedule"}]}]},{"description":"THORA W IMAG OP CLI HOSP PF","code_information":[{"code":"3498200148","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":280.64,"maximum":841.92,"gross_charge":877,"discounted_cash":508.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":833.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":841.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":640.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":727.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":640.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":420.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":304.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":280.64,"methodology":"fee schedule"}]}]},{"description":"GLOBAL SURG FOL UP OP CLI HOSP","code_information":[{"code":"3498200905","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":0.01,"maximum":0.01,"gross_charge":0.01,"discounted_cash":0.01,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"}]}]},{"description":"UP EXT STD 2LVL OP CLI HOSP PF","code_information":[{"code":"3498210100","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":101.44,"maximum":304.32,"gross_charge":317,"discounted_cash":183.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":301.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":304.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":231.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":263.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":231.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":152.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":109.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":101.44,"methodology":"fee schedule"}]}]},{"description":"UP EXT STD 3LVL OP CLI HOSP PF","code_information":[{"code":"3498210105","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":119.36,"maximum":358.08,"gross_charge":373,"discounted_cash":216.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":354.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":358.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":272.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":309.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":272.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":179.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":129.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":119.36,"methodology":"fee schedule"}]}]},{"description":"OBS DISCHMGMT<30MINCLI HOSP PF","code_information":[{"code":"3498210220","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":72.32,"maximum":216.96,"gross_charge":226,"discounted_cash":131.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":214.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":216.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":164.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":187.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":164.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.32,"methodology":"fee schedule"}]}]},{"description":"OBS DISCHMGMT>30MINCLI HOSP PF","code_information":[{"code":"3498210221","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":102.4,"maximum":307.2,"gross_charge":320,"discounted_cash":185.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":304,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":307.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":233.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":265.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":233.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":110.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":102.4,"methodology":"fee schedule"}]}]},{"description":"OBS INIT CARE LVL1 CLI HOSP PF","code_information":[{"code":"3498210222","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":72.64,"maximum":217.92,"gross_charge":227,"discounted_cash":131.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":215.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":188.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.64,"methodology":"fee schedule"}]}]},{"description":"OBS INIT CARE LVL2 CLI HOSP PF","code_information":[{"code":"3498210223","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":115.52,"maximum":346.56,"gross_charge":361,"discounted_cash":209.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":342.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":346.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":299.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":173.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":125.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":115.52,"methodology":"fee schedule"}]}]},{"description":"OBS INIT CARE LVL3 CLI HOSP PF","code_information":[{"code":"3498210224","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":153.92,"maximum":461.76,"gross_charge":481,"discounted_cash":278.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":456.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":461.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":351.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":399.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":351.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":230.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":166.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":153.92,"methodology":"fee schedule"}]}]},{"description":"OBS SUBS CARE LVL1 CLI HOSP PF","code_information":[{"code":"3498210225","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":43.52,"maximum":130.56,"gross_charge":136,"discounted_cash":78.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":129.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":130.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":99.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":112.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":99.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":47.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":43.52,"methodology":"fee schedule"}]}]},{"description":"OBS SUBS CARE LVL2 CLI HOSP PF","code_information":[{"code":"3498210226","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":70.4,"maximum":211.2,"gross_charge":220,"discounted_cash":127.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":209,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":160.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":182.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":160.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":105.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":76.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":70.4,"methodology":"fee schedule"}]}]},{"description":"OBS SUBS CARE LVL3 CLI HOSP PF","code_information":[{"code":"3498210227","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":105.28,"maximum":315.84,"gross_charge":329,"discounted_cash":190.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":312.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":315.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":157.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":114.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":105.28,"methodology":"fee schedule"}]}]},{"description":"OFF/OP VIS NEW LVL 3 SLEEP PF","code_information":[{"code":"3498210250","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":101.76,"maximum":305.28,"gross_charge":318,"discounted_cash":184.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":302.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":305.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":232.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":263.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":232.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":110.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":101.76,"methodology":"fee schedule"}]}]},{"description":"OFF/OP VIS EST LVL 3 SLEEP PF","code_information":[{"code":"3498210251","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":83.52,"maximum":250.56,"gross_charge":261,"discounted_cash":151.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":247.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":250.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":190.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":216.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":190.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":125.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":83.52,"methodology":"fee schedule"}]}]},{"description":"OFF/OP VIS EST LVL 4 SLEEP PF","code_information":[{"code":"3498210252","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":117.76,"maximum":353.28,"gross_charge":368,"discounted_cash":213.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":349.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":353.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":268.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":305.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":268.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":176.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":127.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":117.76,"methodology":"fee schedule"}]}]},{"description":"OFF/OP VIS EST LVL 5 SLEEP PF","code_information":[{"code":"3498210253","type":"CDM"},{"code":"0982","type":"RC"}],"standard_charges":[{"minimum":165.12,"maximum":495.36,"gross_charge":516,"discounted_cash":299.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":490.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":495.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":428.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":247.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":178.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":165.12,"methodology":"fee schedule"}]}]},{"description":"OFF/OP NEW LVL 2 CLIN PF","code_information":[{"code":"3498310115","type":"CDM"},{"code":"0983","type":"RC"}],"standard_charges":[{"minimum":48.96,"maximum":146.88,"gross_charge":153,"discounted_cash":88.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":145.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":146.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":111.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":111.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":53.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":48.96,"methodology":"fee schedule"}]}]},{"description":"OFF/OP NEW LVL 3 CLIN PF","code_information":[{"code":"3498310125","type":"CDM"},{"code":"0983","type":"RC"}],"standard_charges":[{"minimum":75.84,"maximum":227.52,"gross_charge":237,"discounted_cash":137.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":225.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":227.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":173.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":196.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":173.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":82.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"}]}]},{"description":"OFF/OP NEW LVL 4 CLIN PF","code_information":[{"code":"3498310135","type":"CDM"},{"code":"0983","type":"RC"}],"standard_charges":[{"minimum":113.6,"maximum":340.8,"gross_charge":355,"discounted_cash":205.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":337.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":340.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":259.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":294.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":259.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":123.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":113.6,"methodology":"fee schedule"}]}]},{"description":"OFF/OP NEW LVL 5 CLIN PF","code_information":[{"code":"3498310145","type":"CDM"},{"code":"0983","type":"RC"}],"standard_charges":[{"minimum":149.76,"maximum":449.28,"gross_charge":468,"discounted_cash":271.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":444.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":449.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":341.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":388.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":341.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":224.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":162.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":149.76,"methodology":"fee schedule"}]}]},{"description":"OFF/OP EST LVL 1 CLIN PF","code_information":[{"code":"3498310155","type":"CDM"},{"code":"0983","type":"RC"}],"standard_charges":[{"minimum":16.32,"maximum":48.96,"gross_charge":51,"discounted_cash":29.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":48.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":48.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":37.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":42.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":37.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":24.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":17.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.32,"methodology":"fee schedule"}]}]},{"description":"OFF/OP EST LVL 2 CLIN PF","code_information":[{"code":"3498310165","type":"CDM"},{"code":"0983","type":"RC"}],"standard_charges":[{"minimum":38.72,"maximum":116.16,"gross_charge":121,"discounted_cash":70.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":114.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":116.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":88.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":100.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":88.33,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":58.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":41.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":38.72,"methodology":"fee schedule"}]}]},{"description":"OFF/OP EST LVL 3 CLIN PF","code_information":[{"code":"3498310175","type":"CDM"},{"code":"0983","type":"RC"}],"standard_charges":[{"minimum":62.4,"maximum":187.2,"gross_charge":195,"discounted_cash":113.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":185.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":187.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":142.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":161.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":142.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":67.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":62.4,"methodology":"fee schedule"}]}]},{"description":"OFF/OP EST LVL 4 CLIN PF","code_information":[{"code":"3498310185","type":"CDM"},{"code":"0983","type":"RC"}],"standard_charges":[{"minimum":87.68,"maximum":263.04,"gross_charge":274,"discounted_cash":158.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":260.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":263.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":200.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":227.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":200.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":131.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":95.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":87.68,"methodology":"fee schedule"}]}]},{"description":"OFF/OP EST LVL 5 CLIN PF","code_information":[{"code":"3498310195","type":"CDM"},{"code":"0983","type":"RC"}],"standard_charges":[{"minimum":122.88,"maximum":368.64,"gross_charge":384,"discounted_cash":222.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":364.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":368.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":280.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":318.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":280.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":184.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":133.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":122.88,"methodology":"fee schedule"}]}]},{"description":"CV STRESS TEST PHYS SUPERV PF","code_information":[{"code":"3498510100","type":"CDM"},{"code":"0985","type":"RC"}],"standard_charges":[{"minimum":18.88,"maximum":56.64,"gross_charge":59,"discounted_cash":34.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":56.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":56.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":43.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":48.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":43.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":28.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":20.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.88,"methodology":"fee schedule"}]}]},{"description":"EKG 12+ LEADS I&R ONLY HOSP PF","code_information":[{"code":"3498510102","type":"CDM"},{"code":"0985","type":"RC"}],"standard_charges":[{"minimum":7.04,"maximum":21.12,"gross_charge":22,"discounted_cash":12.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":20.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":21.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":18.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":10.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.04,"methodology":"fee schedule"}]}]},{"description":"CV STRESS TEST INT & RPT PF","code_information":[{"code":"3498510105","type":"CDM"},{"code":"0985","type":"RC"}],"standard_charges":[{"minimum":12.8,"maximum":38.4,"gross_charge":40,"discounted_cash":23.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":12.8,"methodology":"fee schedule"}]}]},{"description":"EKG 12+ LEADS I&R ONLY ER PF","code_information":[{"code":"3498510115","type":"CDM"},{"code":"0985","type":"RC"}],"standard_charges":[{"minimum":9.6,"maximum":28.8,"gross_charge":30,"discounted_cash":17.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":28.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":28.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":14.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.6,"methodology":"fee schedule"}]}]},{"description":"EXT ECG>48HR<7D REV & INT PF","code_information":[{"code":"3498510120","type":"CDM"},{"code":"0985","type":"RC"}],"standard_charges":[{"minimum":20.48,"maximum":61.44,"gross_charge":64,"discounted_cash":37.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":60.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":61.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":46.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":53.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":46.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":30.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":22.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":20.48,"methodology":"fee schedule"}]}]},{"description":"EXT ECG>7D<15D REV & INT PF","code_information":[{"code":"3498510125","type":"CDM"},{"code":"0985","type":"RC"}],"standard_charges":[{"minimum":22.72,"maximum":68.16,"gross_charge":71,"discounted_cash":41.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":67.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":68.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":51.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":58.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":51.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":34.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":24.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":22.72,"methodology":"fee schedule"}]}]},{"description":"INSERT PLEURAL CATH HOSP IP","code_information":[{"code":"3498700105","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":713.6,"maximum":2140.8,"gross_charge":2230,"discounted_cash":1293.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2118.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2140.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1627.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1850.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1627.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1070.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":773.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":713.6,"methodology":"fee schedule"}]}]},{"description":"IP ADMIT/DIS LVL 1 CLI HOSP PF","code_information":[{"code":"3498700600","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":86.4,"maximum":259.2,"gross_charge":270,"discounted_cash":156.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":256.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":259.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":197.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":224.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":197.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":129.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":93.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":86.4,"methodology":"fee schedule"}]}]},{"description":"IP ADMIT/DIS LVL2 CLI HOSP PF","code_information":[{"code":"3498700605","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":140.8,"maximum":422.4,"gross_charge":440,"discounted_cash":255.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":418,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":422.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":321.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":365.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":321.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":152.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":140.8,"methodology":"fee schedule"}]}]},{"description":"IP ADMIT/DIS LVL3 CLI HOSP PF","code_information":[{"code":"3498700610","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":204.48,"maximum":613.44,"gross_charge":639,"discounted_cash":370.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":607.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":613.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":466.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":530.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":466.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":306.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":221.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":204.48,"methodology":"fee schedule"}]}]},{"description":"THORA W IMAG IP HOSP PF","code_information":[{"code":"3498710200","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":280.64,"maximum":841.92,"gross_charge":877,"discounted_cash":508.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":833.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":841.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":640.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":727.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":640.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":420.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":304.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":280.64,"methodology":"fee schedule"}]}]},{"description":"ABD PARA W GUIDE IP HOSP PF","code_information":[{"code":"3498710201","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":282.88,"maximum":848.64,"gross_charge":884,"discounted_cash":512.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":839.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":848.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":645.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":733.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":645.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":424.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":306.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":282.88,"methodology":"fee schedule"}]}]},{"description":"GLOBAL SURG FOLLOW UP IP HOSP","code_information":[{"code":"3498710202","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":0.01,"maximum":0.01,"gross_charge":0.01,"discounted_cash":0.01,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"}]}]},{"description":"IP INIT HOSP CARE LVL1 HOSP PF","code_information":[{"code":"3498710203","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":72.64,"maximum":217.92,"gross_charge":227,"discounted_cash":131.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":215.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":188.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.64,"methodology":"fee schedule"}]}]},{"description":"IP INIT HOSP CARE LVL2 HOSP PF","code_information":[{"code":"3498710204","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":115.52,"maximum":346.56,"gross_charge":361,"discounted_cash":209.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":342.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":346.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":299.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":173.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":125.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":115.52,"methodology":"fee schedule"}]}]},{"description":"IP INIT HOSP CARE LVL3 HOSP PF","code_information":[{"code":"3498710205","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":153.92,"maximum":461.76,"gross_charge":481,"discounted_cash":278.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":456.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":461.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":351.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":399.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":351.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":230.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":166.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":153.92,"methodology":"fee schedule"}]}]},{"description":"IP SUBS HOSP CARE LVL1 HOSP PF","code_information":[{"code":"3498710206","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":43.52,"maximum":130.56,"gross_charge":136,"discounted_cash":78.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":129.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":130.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":99.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":112.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":99.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":65.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":47.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":43.52,"methodology":"fee schedule"}]}]},{"description":"IP SUBS HOSP CARE LVL2 HOSP PF","code_information":[{"code":"3498710207","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":70.4,"maximum":211.2,"gross_charge":220,"discounted_cash":127.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":209,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":160.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":182.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":160.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":105.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":76.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":70.4,"methodology":"fee schedule"}]}]},{"description":"IP SUBS HOSP CARE LVL3 HOSP PF","code_information":[{"code":"3498710208","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":105.28,"maximum":315.84,"gross_charge":329,"discounted_cash":190.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":312.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":315.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":157.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":114.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":105.28,"methodology":"fee schedule"}]}]},{"description":"IP HOSP DIS <= 30 MINS HOSP PF","code_information":[{"code":"3498710212","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":72.32,"maximum":216.96,"gross_charge":226,"discounted_cash":131.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":214.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":216.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":164.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":187.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":164.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.32,"methodology":"fee schedule"}]}]},{"description":"IP HOSP DIS > 30 MINS HOSP PF","code_information":[{"code":"3498710213","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":102.4,"maximum":307.2,"gross_charge":320,"discounted_cash":185.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":304,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":307.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":233.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":265.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":233.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":153.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":110.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":102.4,"methodology":"fee schedule"}]}]},{"description":"SWG INIT HOSPCARE LVL1 HOSP PF","code_information":[{"code":"3498710214","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":71.68,"maximum":215.04,"gross_charge":224,"discounted_cash":129.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":212.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":215.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":163.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":185.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":163.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":107.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":77.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":71.68,"methodology":"fee schedule"}]}]},{"description":"SWG INIT HOSPCARE LVL2 HOSP PF","code_information":[{"code":"3498710215","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":119.36,"maximum":358.08,"gross_charge":373,"discounted_cash":216.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":354.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":358.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":272.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":309.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":272.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":179.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":129.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":119.36,"methodology":"fee schedule"}]}]},{"description":"SWG INIT HOSPCARE LVL3 HOSP PF","code_information":[{"code":"3498710216","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":162.88,"maximum":488.64,"gross_charge":509,"discounted_cash":295.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":483.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":488.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":371.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":422.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":371.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":244.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":176.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":162.88,"methodology":"fee schedule"}]}]},{"description":"SWG SUBS HOSPCARE LVL1 HOSP PF","code_information":[{"code":"3498710217","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":35.84,"maximum":107.52,"gross_charge":112,"discounted_cash":64.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":106.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":107.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":81.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":92.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":81.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":53.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":38.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":35.84,"methodology":"fee schedule"}]}]},{"description":"SWG SUBS HOSPCARE LVL2 HOSP PF","code_information":[{"code":"3498710218","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":66.88,"maximum":200.64,"gross_charge":209,"discounted_cash":121.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":198.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":200.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":152.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":173.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":152.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":100.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":72.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":66.88,"methodology":"fee schedule"}]}]},{"description":"SWG SUBS HOSPCARE LVL3 HOSP PF","code_information":[{"code":"3498710219","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":96.64,"maximum":289.92,"gross_charge":302,"discounted_cash":175.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":286.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":289.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":220.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":250.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":220.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":144.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":104.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":96.64,"methodology":"fee schedule"}]}]},{"description":"SWG SUBS HOSPCARE LVL4 HOSP PF","code_information":[{"code":"3498710220","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":137.6,"maximum":412.8,"gross_charge":430,"discounted_cash":249.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":408.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":412.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":313.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":356.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":313.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":206.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":149.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":137.6,"methodology":"fee schedule"}]}]},{"description":"SWG HOSP DIS<=30MINS HOSP PF","code_information":[{"code":"3498710221","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":72.96,"maximum":218.88,"gross_charge":228,"discounted_cash":132.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":216.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":218.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":166.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":189.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":166.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":79.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.96,"methodology":"fee schedule"}]}]},{"description":"SWG HOSP DIS>30MINS HOSP PF","code_information":[{"code":"3498710222","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":116.8,"maximum":350.4,"gross_charge":365,"discounted_cash":211.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":346.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":350.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":266.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":302.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":266.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":175.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":126.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":116.8,"methodology":"fee schedule"}]}]},{"description":"INTUBATION ENDOTRACH HOSP IP","code_information":[{"code":"3498710223","type":"CDM"},{"code":"0987","type":"RC"}],"standard_charges":[{"minimum":107.52,"maximum":322.56,"gross_charge":336,"discounted_cash":194.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":319.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":322.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":245.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":278.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":245.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":161.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":116.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":107.52,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC 3.3X322MM","code_information":[{"code":"349878","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":417.56,"maximum":549.12,"gross_charge":572,"discounted_cash":331.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":543.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":549.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":417.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":474.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":417.56,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC 3.3X322MM","code_information":[{"code":"349878","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":183.04,"maximum":549.12,"gross_charge":572,"discounted_cash":331.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":543.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":549.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":417.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":474.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":417.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":274.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":198.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":183.04,"methodology":"fee schedule"}]}]},{"description":"PIN FIX TEMP","code_information":[{"code":"349880","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":862.13,"maximum":1133.76,"gross_charge":1181,"discounted_cash":684.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1121.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1133.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":862.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":980.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":862.13,"methodology":"fee schedule"}]}]},{"description":"PIN FIX TEMP","code_information":[{"code":"349880","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":377.92,"maximum":1133.76,"gross_charge":1181,"discounted_cash":684.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1121.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1133.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":862.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":980.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":862.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":566.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":409.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":377.92,"methodology":"fee schedule"}]}]},{"description":"TELEPSYCH IP SUBS LTD 15MIN MS","code_information":[{"code":"3498810100","type":"CDM"},{"code":"0988","type":"RC"}],"standard_charges":[{"minimum":53.44,"maximum":160.32,"gross_charge":167,"discounted_cash":96.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":158.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":160.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":121.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":138.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":121.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":80.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":57.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":53.44,"methodology":"fee schedule"}]}]},{"description":"TELEPSYCH IP SUBS INT 25MIN MS","code_information":[{"code":"3498810105","type":"CDM"},{"code":"0988","type":"RC"}],"standard_charges":[{"minimum":97.28,"maximum":291.84,"gross_charge":304,"discounted_cash":176.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":288.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":291.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":221.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":252.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":221.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":145.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":105.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":97.28,"methodology":"fee schedule"}]}]},{"description":"TELEPSYCH IP SUB COMP 35MIN MS","code_information":[{"code":"3498810110","type":"CDM"},{"code":"0988","type":"RC"}],"standard_charges":[{"minimum":139.84,"maximum":419.52,"gross_charge":437,"discounted_cash":253.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":415.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":419.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":319.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":362.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":319.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":209.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":151.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":139.84,"methodology":"fee schedule"}]}]},{"description":"TELEPSYCH ER/IP INIT 30 MIN MS","code_information":[{"code":"3498810115","type":"CDM"},{"code":"0988","type":"RC"}],"standard_charges":[{"minimum":135.36,"maximum":406.08,"gross_charge":423,"discounted_cash":245.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":401.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":308.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":351.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":308.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":203.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":146.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":135.36,"methodology":"fee schedule"}]}]},{"description":"TELEPSYCH ER/IP INIT 30 MIN ER","code_information":[{"code":"3498810120","type":"CDM"},{"code":"0988","type":"RC"}],"standard_charges":[{"minimum":133.76,"maximum":401.28,"gross_charge":418,"discounted_cash":242.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":397.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":401.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":305.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":346.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":305.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":200.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":144.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":133.76,"methodology":"fee schedule"}]}]},{"description":"TELEPSYCH ER/IP INIT 50 MIN MS","code_information":[{"code":"3498810125","type":"CDM"},{"code":"0988","type":"RC"}],"standard_charges":[{"minimum":184,"maximum":552,"gross_charge":575,"discounted_cash":333.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":546.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":552,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":419.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":477.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":419.75,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":276,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":199.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":184,"methodology":"fee schedule"}]}]},{"description":"TELEPSYCH ER/IP INIT 50 MIN ER","code_information":[{"code":"3498810130","type":"CDM"},{"code":"0988","type":"RC"}],"standard_charges":[{"minimum":182.08,"maximum":546.24,"gross_charge":569,"discounted_cash":330.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":540.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":546.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":415.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":472.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":415.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":273.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":197.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":182.08,"methodology":"fee schedule"}]}]},{"description":"TELEPSYCH ER/IP INIT 70 MIN MS","code_information":[{"code":"3498810135","type":"CDM"},{"code":"0988","type":"RC"}],"standard_charges":[{"minimum":273.92,"maximum":821.76,"gross_charge":856,"discounted_cash":496.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":813.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":821.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":624.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":710.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":624.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":410.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":296.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":273.92,"methodology":"fee schedule"}]}]},{"description":"TELEPSYCH ER/IP INIT 70 MIN ER","code_information":[{"code":"3498810140","type":"CDM"},{"code":"0988","type":"RC"}],"standard_charges":[{"minimum":271.36,"maximum":814.08,"gross_charge":848,"discounted_cash":491.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":805.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":814.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":619.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":703.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":619.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":407.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":294.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":271.36,"methodology":"fee schedule"}]}]},{"description":"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES","code_information":[{"code":"3511","type":"APR-DRG"}],"standard_charges":[{"minimum":11687,"maximum":11687,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11687,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES","code_information":[{"code":"3512","type":"APR-DRG"}],"standard_charges":[{"minimum":14818,"maximum":14818,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14818,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES","code_information":[{"code":"3513","type":"APR-DRG"}],"standard_charges":[{"minimum":17779,"maximum":17779,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17779,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES","code_information":[{"code":"3514","type":"APR-DRG"}],"standard_charges":[{"minimum":41782,"maximum":41782,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41782,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COLLAR USS F/6MM ROD","code_information":[{"code":"356830","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":488.37,"maximum":642.24,"gross_charge":669,"discounted_cash":388.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":635.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":642.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":488.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":555.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":488.37,"methodology":"fee schedule"}]}]},{"description":"COLLAR USS F/6MM ROD","code_information":[{"code":"356830","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":214.08,"maximum":642.24,"gross_charge":669,"discounted_cash":388.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":635.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":642.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":488.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":555.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":488.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":321.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":232.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":214.08,"methodology":"fee schedule"}]}]},{"description":"TAP CANN 5MM DUAL CORE SCR","code_information":[{"code":"359159","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":917.61,"maximum":1206.72,"gross_charge":1257,"discounted_cash":729.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1194.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1206.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":917.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1043.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":917.61,"methodology":"fee schedule"}]}]},{"description":"TAP CANN 5MM DUAL CORE SCR","code_information":[{"code":"359159","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":402.24,"maximum":1206.72,"gross_charge":1257,"discounted_cash":729.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1194.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1206.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":917.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1043.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":917.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":603.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":435.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":402.24,"methodology":"fee schedule"}]}]},{"description":"WIRE-K W/TRCR PT 1.6MM 480MM","code_information":[{"code":"359164","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":161.33,"maximum":212.16,"gross_charge":221,"discounted_cash":128.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":209.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":212.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":161.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":183.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":161.33,"methodology":"fee schedule"}]}]},{"description":"WIRE-K W/TRCR PT 1.6MM 480MM","code_information":[{"code":"359164","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":70.72,"maximum":212.16,"gross_charge":221,"discounted_cash":128.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":209.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":212.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":161.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":183.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":161.33,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":106.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":76.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":70.72,"methodology":"fee schedule"}]}]},{"description":"SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES","code_information":[{"code":"3611","type":"APR-DRG"}],"standard_charges":[{"minimum":28212,"maximum":28212,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28212,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES","code_information":[{"code":"3612","type":"APR-DRG"}],"standard_charges":[{"minimum":42128,"maximum":42128,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":42128,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MEDICAL/MONITOR","code_information":[{"code":"3612100000","type":"CDM"},{"code":"0121","type":"RC"}],"standard_charges":[{"minimum":1668.78,"maximum":2194.56,"gross_charge":2286,"discounted_cash":1325.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2171.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2194.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1668.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1897.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1668.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RM MED-SURG","code_information":[{"code":"3612100005","type":"CDM"},{"code":"0120","type":"RC"}],"standard_charges":[{"minimum":1246.84,"maximum":1639.68,"gross_charge":1708,"discounted_cash":990.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1622.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1639.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1246.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1417.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1246.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SWING BED ROOM","code_information":[{"code":"3612100010","type":"CDM"},{"code":"0121","type":"RC"}],"standard_charges":[{"minimum":694.23,"maximum":912.96,"gross_charge":951,"discounted_cash":551.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":903.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":912.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":694.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":789.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":694.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OBSTETRIC RM","code_information":[{"code":"3612200000","type":"CDM"},{"code":"0122","type":"RC"}],"standard_charges":[{"minimum":1492.12,"maximum":1962.24,"gross_charge":2044,"discounted_cash":1185.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1941.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1962.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1492.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1696.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1492.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PEDIATRICS","code_information":[{"code":"3612300000","type":"CDM"},{"code":"0123","type":"RC"}],"standard_charges":[{"minimum":1246.84,"maximum":1639.68,"gross_charge":1708,"discounted_cash":990.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1622.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1639.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1246.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1417.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1246.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES","code_information":[{"code":"3613","type":"APR-DRG"}],"standard_charges":[{"minimum":65720,"maximum":65720,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":65720,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES","code_information":[{"code":"3614","type":"APR-DRG"}],"standard_charges":[{"minimum":135975,"maximum":135975,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":135975,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"IMP HOLLYWOOD VI 11X27X14MM","code_information":[{"code":"361688","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":5977.97,"maximum":7861.44,"gross_charge":8189,"discounted_cash":4749.62,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7779.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7861.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5977.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6796.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5977.97,"methodology":"fee schedule"}]}]},{"description":"IMP HOLLYWOOD VI 11X27X14MM","code_information":[{"code":"361688","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2620.48,"maximum":7861.44,"gross_charge":8189,"discounted_cash":4749.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7779.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7861.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5977.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6796.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5977.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3930.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2839.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2620.48,"methodology":"fee schedule"}]}]},{"description":"NURSERY","code_information":[{"code":"3617100000","type":"CDM"},{"code":"0171","type":"RC"}],"standard_charges":[{"minimum":764.31,"maximum":1005.12,"gross_charge":1047,"discounted_cash":607.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":994.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1005.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":764.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":869.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":764.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NURSERY LEVEL II","code_information":[{"code":"3617200000","type":"CDM"},{"code":"0172","type":"RC"}],"standard_charges":[{"minimum":1004.48,"maximum":1320.96,"gross_charge":1376,"discounted_cash":798.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1307.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1320.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1004.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1142.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1004.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NURSERY LEVEL III","code_information":[{"code":"3617300000","type":"CDM"},{"code":"0173","type":"RC"}],"standard_charges":[{"minimum":1276.77,"maximum":1679.04,"gross_charge":1749,"discounted_cash":1014.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1661.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1679.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1276.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1451.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1276.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CLIP OCCIPITAL","code_information":[{"code":"361829","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":150.38,"maximum":197.76,"gross_charge":206,"discounted_cash":119.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":195.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":197.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":170.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":150.38,"methodology":"fee schedule"}]}]},{"description":"CLIP OCCIPITAL","code_information":[{"code":"361829","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":65.92,"maximum":197.76,"gross_charge":206,"discounted_cash":119.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":195.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":197.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":170.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":71.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":65.92,"methodology":"fee schedule"}]}]},{"description":"MASTECTOMY PROCEDURES","code_information":[{"code":"3621","type":"APR-DRG"}],"standard_charges":[{"minimum":28901,"maximum":28901,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28901,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MASTECTOMY PROCEDURES","code_information":[{"code":"3622","type":"APR-DRG"}],"standard_charges":[{"minimum":38991,"maximum":38991,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38991,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MASTECTOMY PROCEDURES","code_information":[{"code":"3623","type":"APR-DRG"}],"standard_charges":[{"minimum":55591,"maximum":55591,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":55591,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MASTECTOMY PROCEDURES","code_information":[{"code":"3624","type":"APR-DRG"}],"standard_charges":[{"minimum":99863,"maximum":99863,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":99863,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BAR TRNVRS TITANIUM 25MM","code_information":[{"code":"362765","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":413.18,"maximum":543.36,"gross_charge":566,"discounted_cash":328.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":537.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":543.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":413.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":469.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":413.18,"methodology":"fee schedule"}]}]},{"description":"BAR TRNVRS TITANIUM 25MM","code_information":[{"code":"362765","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":181.12,"maximum":543.36,"gross_charge":566,"discounted_cash":328.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":537.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":543.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":413.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":469.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":413.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":271.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":196.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":181.12,"methodology":"fee schedule"}]}]},{"description":"BREAST PROCEDURES EXCEPT MASTECTOMY","code_information":[{"code":"3631","type":"APR-DRG"}],"standard_charges":[{"minimum":31784,"maximum":31784,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31784,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BREAST PROCEDURES EXCEPT MASTECTOMY","code_information":[{"code":"3632","type":"APR-DRG"}],"standard_charges":[{"minimum":46121,"maximum":46121,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46121,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BREAST PROCEDURES EXCEPT MASTECTOMY","code_information":[{"code":"3633","type":"APR-DRG"}],"standard_charges":[{"minimum":61879,"maximum":61879,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":61879,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BREAST PROCEDURES EXCEPT MASTECTOMY","code_information":[{"code":"3634","type":"APR-DRG"}],"standard_charges":[{"minimum":80703,"maximum":80703,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":80703,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BSKT ROT POLYP RETRV 13MM","code_information":[{"code":"363454","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":240.9,"maximum":316.8,"gross_charge":330,"discounted_cash":191.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":313.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":316.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.9,"methodology":"fee schedule"}]}]},{"description":"BSKT ROT POLYP RETRV 13MM","code_information":[{"code":"363454","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":105.6,"maximum":316.8,"gross_charge":330,"discounted_cash":191.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":313.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":316.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":114.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":105.6,"methodology":"fee schedule"}]}]},{"description":"COMPLEX CYSTOMETROGRAM","code_information":[{"code":"3636000300","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":358.43,"maximum":471.36,"gross_charge":491,"discounted_cash":284.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":466.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":471.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":358.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":407.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":358.43,"methodology":"fee schedule"}]}]},{"description":"COMPLEX CYSTOMETROGRAM","code_information":[{"code":"3636000300","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":157.12,"maximum":471.36,"gross_charge":491,"discounted_cash":284.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":466.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":471.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":358.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":407.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":358.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":235.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":170.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":157.12,"methodology":"fee schedule"}]}]},{"description":"COMPLEX UROFLOWMETRY","code_information":[{"code":"3636000305","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":181.04,"maximum":238.08,"gross_charge":248,"discounted_cash":143.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":235.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":238.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":181.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":205.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":181.04,"methodology":"fee schedule"}]}]},{"description":"COMPLEX UROFLOWMETRY","code_information":[{"code":"3636000305","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":79.36,"maximum":238.08,"gross_charge":248,"discounted_cash":143.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":235.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":238.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":181.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":205.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":181.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":86.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":79.36,"methodology":"fee schedule"}]}]},{"description":"YAGLASER(EYE)","code_information":[{"code":"3636010100","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":581.81,"maximum":765.12,"gross_charge":797,"discounted_cash":462.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":757.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":765.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":581.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":661.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":581.81,"methodology":"fee schedule"}]}]},{"description":"YAGLASER(EYE)","code_information":[{"code":"3636010100","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":255.04,"maximum":765.12,"gross_charge":797,"discounted_cash":462.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":757.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":765.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":581.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":661.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":581.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":382.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":276.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":255.04,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 FIRST 30 MINS","code_information":[{"code":"3636010105","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2351.33,"maximum":3092.16,"gross_charge":3221,"discounted_cash":1868.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3059.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3092.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2351.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2673.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2351.33,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 FIRST 30 MINS","code_information":[{"code":"3636010105","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1030.72,"maximum":3092.16,"gross_charge":3221,"discounted_cash":1868.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3059.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3092.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2351.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2673.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2351.33,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1546.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1117.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1030.72,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 ADDL 15 MINS","code_information":[{"code":"3636010110","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":288.35,"maximum":379.2,"gross_charge":395,"discounted_cash":229.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":375.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":379.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":288.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":327.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":288.35,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 ADDL 15 MINS","code_information":[{"code":"3636010110","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":126.4,"maximum":379.2,"gross_charge":395,"discounted_cash":229.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":375.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":379.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":288.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":327.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":288.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":189.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":136.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":126.4,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 FIRST 30 MINS","code_information":[{"code":"3636010115","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2832.4,"maximum":3724.8,"gross_charge":3880,"discounted_cash":2250.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3686,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3724.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2832.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3220.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2832.4,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 FIRST 30 MINS","code_information":[{"code":"3636010115","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1241.6,"maximum":3724.8,"gross_charge":3880,"discounted_cash":2250.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3686,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3724.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2832.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3220.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2832.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1862.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1345.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1241.6,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 ADDL 15 MINS","code_information":[{"code":"3636010120","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":376.68,"maximum":495.36,"gross_charge":516,"discounted_cash":299.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":490.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":495.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":428.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":376.68,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 ADDL 15 MINS","code_information":[{"code":"3636010120","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":165.12,"maximum":495.36,"gross_charge":516,"discounted_cash":299.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":490.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":495.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":428.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":376.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":247.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":178.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":165.12,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 FIRST 30 MINS","code_information":[{"code":"3636010125","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":3806.22,"maximum":5005.44,"gross_charge":5214,"discounted_cash":3024.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4953.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5005.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3806.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4327.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3806.22,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 FIRST 30 MINS","code_information":[{"code":"3636010125","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1668.48,"maximum":5005.44,"gross_charge":5214,"discounted_cash":3024.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4953.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5005.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3806.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4327.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3806.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2502.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1808.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1668.48,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 ADDL 15 MINS","code_information":[{"code":"3636010130","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":465.01,"maximum":611.52,"gross_charge":637,"discounted_cash":369.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":605.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":611.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":465.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":528.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":465.01,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 ADDL 15 MINS","code_information":[{"code":"3636010130","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":203.84,"maximum":611.52,"gross_charge":637,"discounted_cash":369.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":605.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":611.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":465.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":528.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":465.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":305.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":220.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":203.84,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 FIRST 30 MINS","code_information":[{"code":"3636010135","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":5045.76,"maximum":6635.52,"gross_charge":6912,"discounted_cash":4008.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6566.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6635.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5045.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5736.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5045.76,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 FIRST 30 MINS","code_information":[{"code":"3636010135","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2211.84,"maximum":6635.52,"gross_charge":6912,"discounted_cash":4008.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6566.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6635.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5045.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5736.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5045.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3317.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2397.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2211.84,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 ADDL 15 MINS","code_information":[{"code":"3636010140","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":553.34,"maximum":727.68,"gross_charge":758,"discounted_cash":439.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":720.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":727.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":553.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":629.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":553.34,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 ADDL 15 MINS","code_information":[{"code":"3636010140","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":242.56,"maximum":727.68,"gross_charge":758,"discounted_cash":439.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":720.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":727.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":553.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":629.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":553.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":363.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":262.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":242.56,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 FIRST 30 MINS","code_information":[{"code":"3636010145","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":6405.75,"maximum":8424,"gross_charge":8775,"discounted_cash":5089.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8336.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8424,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6405.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7283.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6405.75,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 FIRST 30 MINS","code_information":[{"code":"3636010145","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2808,"maximum":8424,"gross_charge":8775,"discounted_cash":5089.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8336.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8424,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6405.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7283.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6405.75,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4212,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3043.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2808,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 ADDL 15 MINS","code_information":[{"code":"3636010150","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":643.13,"maximum":845.76,"gross_charge":881,"discounted_cash":510.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":836.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":845.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":643.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":731.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":643.13,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 ADDL 15 MINS","code_information":[{"code":"3636010150","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":281.92,"maximum":845.76,"gross_charge":881,"discounted_cash":510.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":836.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":845.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":643.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":731.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":643.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":422.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":305.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":281.92,"methodology":"fee schedule"}]}]},{"description":"OTHER SKIN SUBCUTANEOUS TISSUE AND RELATED PROCEDURES","code_information":[{"code":"3641","type":"APR-DRG"}],"standard_charges":[{"minimum":15068,"maximum":15068,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15068,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VENIPUNCTURE","code_information":[{"code":"36415","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":24.09,"maximum":31.68,"gross_charge":33,"discounted_cash":19.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":31.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":31.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":24.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":24.09,"methodology":"fee schedule"}]}]},{"description":"VENIPUNCTURE","code_information":[{"code":"36415","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.83,"maximum":31.68,"gross_charge":33,"discounted_cash":19.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":31.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":31.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":24.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":27.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":24.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.27,"standard_charge_algorithm": "Lesser of $9.27 or 102 Percent of Billed Charges","median_amount":11.44,"10th_percentile":10.77,"90th_percentile":11.45,"count":"291","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.83,"standard_charge_algorithm": "Lesser of $8.83 or 100 Percent of Billed Charges","median_amount":33,"10th_percentile":33,"90th_percentile":33,"count":"1 through 10","methodology":"fee schedule"}]}]},{"description":"OTHER SKIN SUBCUTANEOUS TISSUE AND RELATED PROCEDURES","code_information":[{"code":"3642","type":"APR-DRG"}],"standard_charges":[{"minimum":21175,"maximum":21175,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21175,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER SKIN SUBCUTANEOUS TISSUE AND RELATED PROCEDURES","code_information":[{"code":"3643","type":"APR-DRG"}],"standard_charges":[{"minimum":43182,"maximum":43182,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43182,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BLOOD ADMINISTRATION","code_information":[{"code":"36430","type":"CPT"},{"code":"0391","type":"RC"}],"standard_charges":[{"minimum":1000.1,"maximum":1315.2,"gross_charge":1370,"discounted_cash":794.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1301.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1315.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1000.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1137.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1000.1,"methodology":"fee schedule"}]}]},{"description":"BLOOD ADMINISTRATION","code_information":[{"code":"36430","type":"CPT"},{"code":"0391","type":"RC"}],"standard_charges":[{"minimum":438.4,"maximum":1315.2,"gross_charge":1370,"discounted_cash":794.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1301.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1315.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1000.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1137.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1000.1,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":657.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":475.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":438.4,"methodology":"fee schedule"}]}]},{"description":"OTHER SKIN SUBCUTANEOUS TISSUE AND RELATED PROCEDURES","code_information":[{"code":"3644","type":"APR-DRG"}],"standard_charges":[{"minimum":109487,"maximum":109487,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":109487,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPEECH THERAPY","code_information":[{"code":"3644400015","type":"CDM"},{"code":"0444","type":"RC"}],"standard_charges":[{"minimum":91.2,"maximum":273.6,"gross_charge":285,"discounted_cash":165.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":270.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":273.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":208.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":236.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":208.05,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":136.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":98.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":91.2,"methodology":"fee schedule"}]}]},{"description":"DRSNG GZ OIL EMULSION 3X8","code_information":[{"code":"364999","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":3.65,"maximum":4.8,"gross_charge":5,"discounted_cash":2.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3.65,"methodology":"fee schedule"}]}]},{"description":"DRSNG GZ OIL EMULSION 3X8","code_information":[{"code":"364999","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":1.6,"maximum":4.8,"gross_charge":5,"discounted_cash":2.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1.6,"methodology":"fee schedule"}]}]},{"description":"GAUZE XEROFORM CURAD 5X9","code_information":[{"code":"365260","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2.15,"maximum":2.83,"gross_charge":2.94,"discounted_cash":1.71,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2.83,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.15,"methodology":"fee schedule"}]}]},{"description":"GAUZE XEROFORM CURAD 5X9","code_information":[{"code":"365260","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":0.95,"maximum":2.83,"gross_charge":2.94,"discounted_cash":1.71,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2.83,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.95,"methodology":"fee schedule"}]}]},{"description":"DRSNG GAUZE PETROLATUM .5X72","code_information":[{"code":"365261","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":2.95,"maximum":3.88,"gross_charge":4.04,"discounted_cash":2.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.95,"methodology":"fee schedule"}]}]},{"description":"DRSNG GAUZE PETROLATUM .5X72","code_information":[{"code":"365261","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":1.3,"maximum":3.88,"gross_charge":4.04,"discounted_cash":2.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1.94,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1.3,"methodology":"fee schedule"}]}]},{"description":"DRSNG GAUZE PETROLATUM 3X9","code_information":[{"code":"365262","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":2.92,"maximum":3.84,"gross_charge":4,"discounted_cash":2.32,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.92,"methodology":"fee schedule"}]}]},{"description":"DRSNG GAUZE PETROLATUM 3X9","code_information":[{"code":"365262","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":1.28,"maximum":3.84,"gross_charge":4,"discounted_cash":2.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1.28,"methodology":"fee schedule"}]}]},{"description":"RETRIEVER UNIV ROTH NET PLATIN","code_information":[{"code":"365606","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":280.24,"maximum":368.53,"gross_charge":383.88,"discounted_cash":222.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":364.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":368.53,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":280.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":318.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":280.24,"methodology":"fee schedule"}]}]},{"description":"RETRIEVER UNIV ROTH NET PLATIN","code_information":[{"code":"365606","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":122.85,"maximum":368.53,"gross_charge":383.88,"discounted_cash":222.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":364.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":368.53,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":280.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":318.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":280.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":184.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":133.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":122.85,"methodology":"fee schedule"}]}]},{"description":"LAB ARTERIAL PUNCTURE","code_information":[{"code":"36600","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":262.8,"maximum":345.6,"gross_charge":360,"discounted_cash":208.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":342,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":345.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":262.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":262.8,"methodology":"fee schedule"}]}]},{"description":"LAB ARTERIAL PUNCTURE","code_information":[{"code":"36600","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":115.2,"maximum":345.6,"gross_charge":360,"discounted_cash":208.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":342,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":345.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":262.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":298.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":262.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":172.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":124.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":115.2,"methodology":"fee schedule"}]}]},{"description":"DEVICE FIXATION ABSORBABLE 5MM","code_information":[{"code":"367428","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1325.68,"maximum":1743.36,"gross_charge":1816,"discounted_cash":1053.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1725.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1743.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1325.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1507.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1325.68,"methodology":"fee schedule"}]}]},{"description":"DEVICE FIXATION ABSORBABLE 5MM","code_information":[{"code":"367428","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":581.12,"maximum":1743.36,"gross_charge":1816,"discounted_cash":1053.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1725.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1743.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1325.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1507.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1325.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":871.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":629.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":581.12,"methodology":"fee schedule"}]}]},{"description":"CONN TRN MAXTRIX 47-62MM","code_information":[{"code":"368559","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1127.85,"maximum":1483.2,"gross_charge":1545,"discounted_cash":896.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1467.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1483.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1127.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1282.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1127.85,"methodology":"fee schedule"}]}]},{"description":"CONN TRN MAXTRIX 47-62MM","code_information":[{"code":"368559","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":494.4,"maximum":1483.2,"gross_charge":1545,"discounted_cash":896.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1467.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1483.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1127.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1282.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1127.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":741.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":535.81,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":494.4,"methodology":"fee schedule"}]}]},{"description":"HEMOSTAT SURGICEL SNOW 4INX4IN","code_information":[{"code":"370023","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":272.29,"maximum":358.08,"gross_charge":373,"discounted_cash":216.34,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":354.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":358.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":272.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":309.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":272.29,"methodology":"fee schedule"}]}]},{"description":"HEMOSTAT SURGICEL SNOW 4INX4IN","code_information":[{"code":"370023","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":119.36,"maximum":358.08,"gross_charge":373,"discounted_cash":216.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":354.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":358.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":272.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":309.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":272.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":179.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":129.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":119.36,"methodology":"fee schedule"}]}]},{"description":"ROUTINE ROOM","code_information":[{"code":"3712000002","type":"CDM"},{"code":"0120","type":"RC"}],"standard_charges":[{"minimum":1081.13,"maximum":1421.76,"gross_charge":1481,"discounted_cash":858.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1406.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1421.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1081.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1229.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1081.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TAP 5MM","code_information":[{"code":"371281","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":605.17,"maximum":795.84,"gross_charge":829,"discounted_cash":480.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":787.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":795.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":605.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":688.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":605.17,"methodology":"fee schedule"}]}]},{"description":"TAP 5MM","code_information":[{"code":"371281","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":265.28,"maximum":795.84,"gross_charge":829,"discounted_cash":480.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":787.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":795.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":605.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":688.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":605.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":397.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":287.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":265.28,"methodology":"fee schedule"}]}]},{"description":"RESPITE CARE","code_information":[{"code":"3712900001","type":"CDM"},{"code":"0129","type":"RC"}],"standard_charges":[{"minimum":300.76,"maximum":395.52,"gross_charge":412,"discounted_cash":238.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":391.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":395.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":300.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":341.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":300.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SWING BED","code_information":[{"code":"3712900002","type":"CDM"},{"code":"0129","type":"RC"}],"standard_charges":[{"minimum":394.93,"maximum":519.36,"gross_charge":541,"discounted_cash":313.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":513.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":519.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":394.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":449.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":394.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"WIRE-K W/BLNT PT 1.6MM 480MM","code_information":[{"code":"371991","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":156.22,"maximum":205.44,"gross_charge":214,"discounted_cash":124.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":203.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":205.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":156.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":177.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":156.22,"methodology":"fee schedule"}]}]},{"description":"WIRE-K W/BLNT PT 1.6MM 480MM","code_information":[{"code":"371991","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":68.48,"maximum":205.44,"gross_charge":214,"discounted_cash":124.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":203.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":205.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":156.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":177.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":156.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":102.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":74.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":68.48,"methodology":"fee schedule"}]}]},{"description":"HD REDUC POLYAX TI","code_information":[{"code":"372062","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":902.28,"maximum":1186.56,"gross_charge":1236,"discounted_cash":716.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1174.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1186.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":902.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1025.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":902.28,"methodology":"fee schedule"}]}]},{"description":"HD REDUC POLYAX TI","code_information":[{"code":"372062","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":395.52,"maximum":1186.56,"gross_charge":1236,"discounted_cash":716.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1174.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1186.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":902.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1025.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":902.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":593.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":428.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":395.52,"methodology":"fee schedule"}]}]},{"description":"INJECTION PROCCYSTO/VCUG","code_information":[{"code":"3732000026","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":309.52,"maximum":407.04,"gross_charge":424,"discounted_cash":245.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":402.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":407.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":309.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":351.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":309.52,"methodology":"fee schedule"}]}]},{"description":"INJECTION PROCCYSTO/VCUG","code_information":[{"code":"3732000026","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":135.68,"maximum":407.04,"gross_charge":424,"discounted_cash":245.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":402.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":407.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":309.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":351.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":309.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":203.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":147.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":135.68,"methodology":"fee schedule"}]}]},{"description":"TRIGGER POINT INJECTIONS","code_information":[{"code":"3736000199","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":643.86,"maximum":846.72,"gross_charge":882,"discounted_cash":511.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":837.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":846.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":643.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":732.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":643.86,"methodology":"fee schedule"}]}]},{"description":"TRIGGER POINT INJECTIONS","code_information":[{"code":"3736000199","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":282.24,"maximum":846.72,"gross_charge":882,"discounted_cash":511.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":837.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":846.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":643.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":732.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":643.86,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":423.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":305.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":282.24,"methodology":"fee schedule"}]}]},{"description":"SI JOINT INJ W/FLURO-FAC FEE","code_information":[{"code":"3736000204","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":400.04,"maximum":526.08,"gross_charge":548,"discounted_cash":317.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":520.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":526.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":400.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":454.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":400.04,"methodology":"fee schedule"}]}]},{"description":"SI JOINT INJ W/FLURO-FAC FEE","code_information":[{"code":"3736000204","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":175.36,"maximum":526.08,"gross_charge":548,"discounted_cash":317.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":520.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":526.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":400.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":454.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":400.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":263.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":190.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":175.36,"methodology":"fee schedule"}]}]},{"description":"SYMPATHETIC NERVE BLOCK/FACFEE","code_information":[{"code":"3736000206","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1388.46,"maximum":1825.92,"gross_charge":1902,"discounted_cash":1103.16,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1806.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1825.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1388.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1578.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1388.46,"methodology":"fee schedule"}]}]},{"description":"SYMPATHETIC NERVE BLOCK/FACFEE","code_information":[{"code":"3736000206","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":608.64,"maximum":1825.92,"gross_charge":1902,"discounted_cash":1103.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1806.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1825.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1388.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1578.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1388.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":912.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":659.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":608.64,"methodology":"fee schedule"}]}]},{"description":"LUMBAR PUNCTUREDIAG/FAC FEE","code_information":[{"code":"3736000208","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":701.53,"maximum":922.56,"gross_charge":961,"discounted_cash":557.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":912.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":922.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":701.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":797.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":701.53,"methodology":"fee schedule"}]}]},{"description":"LUMBAR PUNCTUREDIAG/FAC FEE","code_information":[{"code":"3736000208","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":307.52,"maximum":922.56,"gross_charge":961,"discounted_cash":557.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":912.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":922.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":701.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":797.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":701.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":461.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":333.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":307.52,"methodology":"fee schedule"}]}]},{"description":"PICC LINE INSERTION/FAC FEE","code_information":[{"code":"3736000209","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2049.11,"maximum":2694.72,"gross_charge":2807,"discounted_cash":1628.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2666.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2694.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2049.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2329.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2049.11,"methodology":"fee schedule"}]}]},{"description":"PICC LINE INSERTION/FAC FEE","code_information":[{"code":"3736000209","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":898.24,"maximum":2694.72,"gross_charge":2807,"discounted_cash":1628.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2666.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2694.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2049.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2329.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2049.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1347.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":973.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":898.24,"methodology":"fee schedule"}]}]},{"description":"SEVERITY LEVEL 5-FIRST HOUR","code_information":[{"code":"3736000237","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":940.97,"maximum":1237.44,"gross_charge":1289,"discounted_cash":747.62,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1224.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1237.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":940.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1069.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":940.97,"methodology":"fee schedule"}]}]},{"description":"SEVERITY LEVEL 5-FIRST HOUR","code_information":[{"code":"3736000237","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":412.48,"maximum":1237.44,"gross_charge":1289,"discounted_cash":747.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1224.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1237.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":940.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1069.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":940.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":618.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":447.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":412.48,"methodology":"fee schedule"}]}]},{"description":"SEVERITY LEVEL 5-ADDL 30 MINS","code_information":[{"code":"3736000238","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":334.34,"maximum":439.68,"gross_charge":458,"discounted_cash":265.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":435.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":439.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":334.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":380.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":334.34,"methodology":"fee schedule"}]}]},{"description":"SEVERITY LEVEL 5-ADDL 30 MINS","code_information":[{"code":"3736000238","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":146.56,"maximum":439.68,"gross_charge":458,"discounted_cash":265.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":435.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":439.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":334.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":380.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":334.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":219.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":158.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":146.56,"methodology":"fee schedule"}]}]},{"description":"TRIGGER POINT INJ 1OR2 MUSCLES","code_information":[{"code":"3736002210","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":484.72,"maximum":637.44,"gross_charge":664,"discounted_cash":385.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":630.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":637.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":484.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":551.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":484.72,"methodology":"fee schedule"}]}]},{"description":"TRIGGER POINT INJ 1OR2 MUSCLES","code_information":[{"code":"3736002210","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":212.48,"maximum":637.44,"gross_charge":664,"discounted_cash":385.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":630.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":637.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":484.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":551.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":484.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":318.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":230.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":212.48,"methodology":"fee schedule"}]}]},{"description":"INJ FORAMEN EPIDURAL L/S","code_information":[{"code":"3736002211","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1495.77,"maximum":1967.04,"gross_charge":2049,"discounted_cash":1188.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1946.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1967.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1495.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1700.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1495.77,"methodology":"fee schedule"}]}]},{"description":"INJ FORAMEN EPIDURAL L/S","code_information":[{"code":"3736002211","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":655.68,"maximum":1967.04,"gross_charge":2049,"discounted_cash":1188.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1946.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1967.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1495.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1700.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1495.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":983.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":710.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":655.68,"methodology":"fee schedule"}]}]},{"description":"INJ FORAMEN EPIDURAL L/S ADDON","code_information":[{"code":"3736002212","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":777.45,"maximum":1022.4,"gross_charge":1065,"discounted_cash":617.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1011.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1022.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":777.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":883.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":777.45,"methodology":"fee schedule"}]}]},{"description":"INJ FORAMEN EPIDURAL L/S ADDON","code_information":[{"code":"3736002212","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":340.8,"maximum":1022.4,"gross_charge":1065,"discounted_cash":617.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1011.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1022.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":777.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":883.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":777.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":511.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":369.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":340.8,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 FIRST 30 MINS","code_information":[{"code":"3736010150","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1600.89,"maximum":2105.28,"gross_charge":2193,"discounted_cash":1271.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2083.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2105.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1600.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1820.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1600.89,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 FIRST 30 MINS","code_information":[{"code":"3736010150","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":701.76,"maximum":2105.28,"gross_charge":2193,"discounted_cash":1271.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2083.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2105.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1600.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1820.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1600.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1052.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":760.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":701.76,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 ADDL 15 MINS","code_information":[{"code":"3736010155","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":321.2,"maximum":422.4,"gross_charge":440,"discounted_cash":255.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":418,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":422.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":321.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":365.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":321.2,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 ADDL 15 MINS","code_information":[{"code":"3736010155","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":140.8,"maximum":422.4,"gross_charge":440,"discounted_cash":255.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":418,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":422.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":321.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":365.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":321.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":211.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":152.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":140.8,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 FIRST 30 MINS","code_information":[{"code":"3736010160","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2749.91,"maximum":3616.32,"gross_charge":3767,"discounted_cash":2184.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3578.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3616.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2749.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3126.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2749.91,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 FIRST 30 MINS","code_information":[{"code":"3736010160","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1205.44,"maximum":3616.32,"gross_charge":3767,"discounted_cash":2184.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3578.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3616.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2749.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3126.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2749.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1808.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1306.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1205.44,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 ADDL 15 MINS","code_information":[{"code":"3736010165","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":551.15,"maximum":724.8,"gross_charge":755,"discounted_cash":437.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":717.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":724.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":551.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":626.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":551.15,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 ADDL 15 MINS","code_information":[{"code":"3736010165","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":241.6,"maximum":724.8,"gross_charge":755,"discounted_cash":437.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":717.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":724.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":551.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":626.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":551.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":362.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":261.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":241.6,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 FIRST 30 MINS","code_information":[{"code":"3736010170","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":4002.59,"maximum":5263.68,"gross_charge":5483,"discounted_cash":3180.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5208.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5263.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4002.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4550.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4002.59,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 FIRST 30 MINS","code_information":[{"code":"3736010170","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1754.56,"maximum":5263.68,"gross_charge":5483,"discounted_cash":3180.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5208.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5263.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4002.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4550.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4002.59,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2631.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1901.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1754.56,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 ADDL 15 MINS","code_information":[{"code":"3736010175","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":800.81,"maximum":1053.12,"gross_charge":1097,"discounted_cash":636.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1042.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1053.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":800.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":910.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":800.81,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 ADDL 15 MINS","code_information":[{"code":"3736010175","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":351.04,"maximum":1053.12,"gross_charge":1097,"discounted_cash":636.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1042.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1053.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":800.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":910.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":800.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":526.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":380.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":351.04,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 FIRST 30 MINS","code_information":[{"code":"3736010180","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":5803.5,"maximum":7632,"gross_charge":7950,"discounted_cash":4611,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7552.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7632,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5803.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6598.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5803.5,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 FIRST 30 MINS","code_information":[{"code":"3736010180","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2544,"maximum":7632,"gross_charge":7950,"discounted_cash":4611,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7552.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7632,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5803.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6598.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5803.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3816,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2757.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2544,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 ADDL 15 MINS","code_information":[{"code":"3736010185","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1161.43,"maximum":1527.36,"gross_charge":1591,"discounted_cash":922.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1511.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1527.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1161.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1320.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1161.43,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 ADDL 15 MINS","code_information":[{"code":"3736010185","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":509.12,"maximum":1527.36,"gross_charge":1591,"discounted_cash":922.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1511.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1527.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1161.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1320.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1161.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":763.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":551.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":509.12,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 FIRST 30 MINS","code_information":[{"code":"3736010190","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":8413.98,"maximum":11064.96,"gross_charge":11526,"discounted_cash":6685.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":10949.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11064.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8413.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9566.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8413.98,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 FIRST 30 MINS","code_information":[{"code":"3736010190","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":3688.32,"maximum":11064.96,"gross_charge":11526,"discounted_cash":6685.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":10949.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11064.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8413.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9566.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8413.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5532.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3997.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3688.32,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 ADDL 15 MINS","code_information":[{"code":"3736010195","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1683.38,"maximum":2213.76,"gross_charge":2306,"discounted_cash":1337.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2190.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2213.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1683.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1913.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1683.38,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 ADDL 15 MINS","code_information":[{"code":"3736010195","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":737.92,"maximum":2213.76,"gross_charge":2306,"discounted_cash":1337.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2190.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2213.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1683.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1913.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1683.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1106.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":799.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":737.92,"methodology":"fee schedule"}]}]},{"description":"FIX SORBAFIX ADVANCE LAPSCP 30","code_information":[{"code":"375275","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1331.52,"maximum":1751.04,"gross_charge":1824,"discounted_cash":1057.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1732.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1751.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1331.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1513.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1331.52,"methodology":"fee schedule"}]}]},{"description":"FIX SORBAFIX ADVANCE LAPSCP 30","code_information":[{"code":"375275","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":583.68,"maximum":1751.04,"gross_charge":1824,"discounted_cash":1057.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1732.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1751.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1331.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1513.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1331.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":875.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":632.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":583.68,"methodology":"fee schedule"}]}]},{"description":"FIX SORBAFIX ADVANCE LAPSCP 15","code_information":[{"code":"375277","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":924.91,"maximum":1216.32,"gross_charge":1267,"discounted_cash":734.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1203.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1216.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":924.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1051.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":924.91,"methodology":"fee schedule"}]}]},{"description":"FIX SORBAFIX ADVANCE LAPSCP 15","code_information":[{"code":"375277","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":405.44,"maximum":1216.32,"gross_charge":1267,"discounted_cash":734.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1203.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1216.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":924.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1051.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":924.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":608.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":439.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":405.44,"methodology":"fee schedule"}]}]},{"description":"END RNG CONVEX 0 DEG 17X22","code_information":[{"code":"378396","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1164.35,"maximum":1531.2,"gross_charge":1595,"discounted_cash":925.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1515.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1531.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1164.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1323.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1164.35,"methodology":"fee schedule"}]}]},{"description":"END RNG CONVEX 0 DEG 17X22","code_information":[{"code":"378396","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":510.4,"maximum":1531.2,"gross_charge":1595,"discounted_cash":925.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1515.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1531.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1164.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1323.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1164.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":765.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":553.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":510.4,"methodology":"fee schedule"}]}]},{"description":"ORACLE SPACER 9MM 55X22MM","code_information":[{"code":"379789","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":8459.24,"maximum":11124.48,"gross_charge":11588,"discounted_cash":6721.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11008.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11124.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8459.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9618.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8459.24,"methodology":"fee schedule"}]}]},{"description":"ORACLE SPACER 9MM 55X22MM","code_information":[{"code":"379789","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":3708.16,"maximum":11124.48,"gross_charge":11588,"discounted_cash":6721.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11008.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11124.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8459.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9618.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8459.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5562.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":4018.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3708.16,"methodology":"fee schedule"}]}]},{"description":"SKIN ULCERS","code_information":[{"code":"3801","type":"APR-DRG"}],"standard_charges":[{"minimum":13385,"maximum":13385,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13385,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SKIN ULCERS","code_information":[{"code":"3802","type":"APR-DRG"}],"standard_charges":[{"minimum":17866,"maximum":17866,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17866,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SKIN ULCERS","code_information":[{"code":"3803","type":"APR-DRG"}],"standard_charges":[{"minimum":25516,"maximum":25516,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25516,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SKIN ULCERS","code_information":[{"code":"3804","type":"APR-DRG"}],"standard_charges":[{"minimum":44978,"maximum":44978,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44978,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR SKIN DISORDERS","code_information":[{"code":"3811","type":"APR-DRG"}],"standard_charges":[{"minimum":8263,"maximum":8263,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":8263,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR SKIN DISORDERS","code_information":[{"code":"3812","type":"APR-DRG"}],"standard_charges":[{"minimum":15544,"maximum":15544,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15544,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR SKIN DISORDERS","code_information":[{"code":"3813","type":"APR-DRG"}],"standard_charges":[{"minimum":30695,"maximum":30695,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30695,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR SKIN DISORDERS","code_information":[{"code":"3814","type":"APR-DRG"}],"standard_charges":[{"minimum":62696,"maximum":62696,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":62696,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALIGNANT BREAST DISORDERS","code_information":[{"code":"3821","type":"APR-DRG"}],"standard_charges":[{"minimum":15275,"maximum":15275,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15275,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALIGNANT BREAST DISORDERS","code_information":[{"code":"3822","type":"APR-DRG"}],"standard_charges":[{"minimum":17225,"maximum":17225,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17225,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIAG BONE MARROW ASP","code_information":[{"code":"38220","type":"CPT"},{"code":"0310","type":"RC"}],"standard_charges":[{"minimum":2497.33,"maximum":3284.16,"gross_charge":3421,"discounted_cash":1984.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3249.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3284.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2497.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2839.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2497.33,"methodology":"fee schedule"}]}]},{"description":"DIAG BONE MARROW ASP","code_information":[{"code":"38220","type":"CPT"},{"code":"0310","type":"RC"}],"standard_charges":[{"minimum":1094.72,"maximum":3284.16,"gross_charge":3421,"discounted_cash":1984.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3249.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3284.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2497.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2839.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2497.33,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1642.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1186.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1094.72,"methodology":"fee schedule"}]}]},{"description":"MALIGNANT BREAST DISORDERS","code_information":[{"code":"3823","type":"APR-DRG"}],"standard_charges":[{"minimum":21686,"maximum":21686,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21686,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALIGNANT BREAST DISORDERS","code_information":[{"code":"3824","type":"APR-DRG"}],"standard_charges":[{"minimum":43493,"maximum":43493,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43493,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CELLULITIS AND OTHER SKIN INFECTIONS","code_information":[{"code":"3831","type":"APR-DRG"}],"standard_charges":[{"minimum":12361,"maximum":12361,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12361,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CELLULITIS AND OTHER SKIN INFECTIONS","code_information":[{"code":"3832","type":"APR-DRG"}],"standard_charges":[{"minimum":16783,"maximum":16783,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16783,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CELLULITIS AND OTHER SKIN INFECTIONS","code_information":[{"code":"3833","type":"APR-DRG"}],"standard_charges":[{"minimum":24353,"maximum":24353,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24353,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CELLULITIS AND OTHER SKIN INFECTIONS","code_information":[{"code":"3834","type":"APR-DRG"}],"standard_charges":[{"minimum":63755,"maximum":63755,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":63755,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CONTUSION OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE","code_information":[{"code":"3841","type":"APR-DRG"}],"standard_charges":[{"minimum":12003,"maximum":12003,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12003,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CONTUSION OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE","code_information":[{"code":"3842","type":"APR-DRG"}],"standard_charges":[{"minimum":16175,"maximum":16175,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16175,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CONTUSION OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE","code_information":[{"code":"3843","type":"APR-DRG"}],"standard_charges":[{"minimum":22723,"maximum":22723,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22723,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CONTUSION OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE","code_information":[{"code":"3844","type":"APR-DRG"}],"standard_charges":[{"minimum":43780,"maximum":43780,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43780,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER SKIN SUBCUTANEOUS TISSUE AND BREAST DISORDERS","code_information":[{"code":"3851","type":"APR-DRG"}],"standard_charges":[{"minimum":9533,"maximum":9533,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9533,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER SKIN SUBCUTANEOUS TISSUE AND BREAST DISORDERS","code_information":[{"code":"3852","type":"APR-DRG"}],"standard_charges":[{"minimum":17699,"maximum":17699,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17699,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER SKIN SUBCUTANEOUS TISSUE AND BREAST DISORDERS","code_information":[{"code":"3853","type":"APR-DRG"}],"standard_charges":[{"minimum":18720,"maximum":18720,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18720,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER SKIN SUBCUTANEOUS TISSUE AND BREAST DISORDERS","code_information":[{"code":"3854","type":"APR-DRG"}],"standard_charges":[{"minimum":42945,"maximum":42945,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":42945,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STAPLER ILS CIRCULAR CRVD 29MM","code_information":[{"code":"386320","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":459.17,"maximum":603.84,"gross_charge":629,"discounted_cash":364.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":597.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":603.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":459.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":522.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":459.17,"methodology":"fee schedule"}]}]},{"description":"STAPLER ILS CIRCULAR CRVD 29MM","code_information":[{"code":"386320","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":201.28,"maximum":603.84,"gross_charge":629,"discounted_cash":364.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":597.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":603.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":459.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":522.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":459.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":301.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":218.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":201.28,"methodology":"fee schedule"}]}]},{"description":"PEEK T-PAL 7MM SM","code_information":[{"code":"387678","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":6992.67,"maximum":9195.84,"gross_charge":9579,"discounted_cash":5555.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":9100.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":9195.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6992.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7950.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6992.67,"methodology":"fee schedule"}]}]},{"description":"PEEK T-PAL 7MM SM","code_information":[{"code":"387678","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":3065.28,"maximum":9195.84,"gross_charge":9579,"discounted_cash":5555.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":9100.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":9195.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6992.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7950.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6992.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4597.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3322,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3065.28,"methodology":"fee schedule"}]}]},{"description":"VEST SMARTVEST WRAP LG","code_information":[{"code":"389888","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":232.14,"maximum":305.28,"gross_charge":318,"discounted_cash":184.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":302.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":305.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":232.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":263.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":232.14,"methodology":"fee schedule"}]}]},{"description":"VEST SMARTVEST WRAP LG","code_information":[{"code":"389888","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":101.76,"maximum":305.28,"gross_charge":318,"discounted_cash":184.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":302.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":305.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":232.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":263.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":232.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":110.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":101.76,"methodology":"fee schedule"}]}]},{"description":"PRIVATE ROOM-MED SURG","code_information":[{"code":"3911000001","type":"CDM"},{"code":"0110","type":"RC"}],"standard_charges":[{"minimum":1011.78,"maximum":1330.56,"gross_charge":1386,"discounted_cash":803.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1316.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1330.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1011.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1150.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1011.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ISOLATION","code_information":[{"code":"3911100001","type":"CDM"},{"code":"0111","type":"RC"}],"standard_charges":[{"minimum":1043.17,"maximum":1371.84,"gross_charge":1429,"discounted_cash":828.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1357.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1371.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1043.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1186.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1043.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SEMI PRIVATE ROOM-MED SUR","code_information":[{"code":"3912000001","type":"CDM"},{"code":"0120","type":"RC"}],"standard_charges":[{"minimum":982.58,"maximum":1292.16,"gross_charge":1346,"discounted_cash":780.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1278.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1292.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":982.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1117.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":982.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SWINGBED SKILLED CARE","code_information":[{"code":"3912000002","type":"CDM"},{"code":"0120","type":"RC"}],"standard_charges":[{"minimum":431.43,"maximum":567.36,"gross_charge":591,"discounted_cash":342.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":561.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":567.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":431.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":490.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":431.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SEMI PRIVATE ROOM-OB","code_information":[{"code":"3912200001","type":"CDM"},{"code":"0122","type":"RC"}],"standard_charges":[{"minimum":982.58,"maximum":1292.16,"gross_charge":1346,"discounted_cash":780.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1278.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1292.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":982.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1117.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":982.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HOSPICE","code_information":[{"code":"3912500001","type":"CDM"},{"code":"0125","type":"RC"}],"standard_charges":[{"minimum":982.58,"maximum":1292.16,"gross_charge":1346,"discounted_cash":780.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1278.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1292.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":982.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1117.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":982.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TY EPIDURAL SNGL DOSE 20G","code_information":[{"code":"391589","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":36.5,"maximum":48,"gross_charge":50,"discounted_cash":29,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":47.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":36.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":36.5,"methodology":"fee schedule"}]}]},{"description":"TY EPIDURAL SNGL DOSE 20G","code_information":[{"code":"391589","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":16,"maximum":48,"gross_charge":50,"discounted_cash":29,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":47.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":36.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":36.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":17.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16,"methodology":"fee schedule"}]}]},{"description":"CATH SUPRPUB PERC STAMEY 14FR","code_information":[{"code":"391590","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":144.54,"maximum":190.08,"gross_charge":198,"discounted_cash":114.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":188.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":190.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":164.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":144.54,"methodology":"fee schedule"}]}]},{"description":"CATH SUPRPUB PERC STAMEY 14FR","code_information":[{"code":"391590","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":63.36,"maximum":190.08,"gross_charge":198,"discounted_cash":114.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":188.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":190.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":164.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":95.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":68.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":63.36,"methodology":"fee schedule"}]}]},{"description":"NURSERY-MOTHER A PATIENT","code_information":[{"code":"3917000001","type":"CDM"},{"code":"0170","type":"RC"}],"standard_charges":[{"minimum":701.53,"maximum":922.56,"gross_charge":961,"discounted_cash":557.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":912.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":922.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":701.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":797.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":701.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SOL ORAL ENTERO VU 24PCT 600X1","code_information":[{"code":"392655","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":46.04,"maximum":60.54,"gross_charge":63.06,"discounted_cash":36.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":59.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":60.54,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":46.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":52.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":46.04,"methodology":"fee schedule"}]}]},{"description":"SOL ORAL ENTERO VU 24PCT 600X1","code_information":[{"code":"392655","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":20.18,"maximum":60.54,"gross_charge":63.06,"discounted_cash":36.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":59.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":60.54,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":46.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":52.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":46.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":30.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":21.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":20.18,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 FIRST 30 MINS","code_information":[{"code":"3936010100","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1616.22,"maximum":2125.44,"gross_charge":2214,"discounted_cash":1284.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2103.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2125.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1616.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1837.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1616.22,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 FIRST 30 MINS","code_information":[{"code":"3936010100","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":708.48,"maximum":2125.44,"gross_charge":2214,"discounted_cash":1284.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2103.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2125.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1616.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1837.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1616.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1062.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":767.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":708.48,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 ADDL 15 MINS","code_information":[{"code":"3936010105","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":324.12,"maximum":426.24,"gross_charge":444,"discounted_cash":257.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":421.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":426.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":324.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":368.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":324.12,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 1 ADDL 15 MINS","code_information":[{"code":"3936010105","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":142.08,"maximum":426.24,"gross_charge":444,"discounted_cash":257.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":421.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":426.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":324.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":368.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":324.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":213.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":153.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 FIRST 30 MINS","code_information":[{"code":"3936010110","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2776.19,"maximum":3650.88,"gross_charge":3803,"discounted_cash":2205.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3612.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3650.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2776.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3156.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2776.19,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 FIRST 30 MINS","code_information":[{"code":"3936010110","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1216.96,"maximum":3650.88,"gross_charge":3803,"discounted_cash":2205.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3612.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3650.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2776.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3156.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2776.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1825.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1318.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1216.96,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 ADDL 15 MINS","code_information":[{"code":"3936010115","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":556.26,"maximum":731.52,"gross_charge":762,"discounted_cash":441.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":723.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":731.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":556.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":632.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":556.26,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 ADDL 15 MINS","code_information":[{"code":"3936010115","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":243.84,"maximum":731.52,"gross_charge":762,"discounted_cash":441.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":723.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":731.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":556.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":632.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":556.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":365.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":264.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":243.84,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 FIRST 30 MINS","code_information":[{"code":"3936010120","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":4040.55,"maximum":5313.6,"gross_charge":5535,"discounted_cash":3210.3,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5258.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5313.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4040.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4594.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4040.55,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 FIRST 30 MINS","code_information":[{"code":"3936010120","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1771.2,"maximum":5313.6,"gross_charge":5535,"discounted_cash":3210.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5258.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5313.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4040.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4594.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4040.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2656.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1919.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1771.2,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 ADDL 15 MINS","code_information":[{"code":"3936010125","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":808.84,"maximum":1063.68,"gross_charge":1108,"discounted_cash":642.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1052.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1063.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":808.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":808.84,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 ADDL 15 MINS","code_information":[{"code":"3936010125","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":354.56,"maximum":1063.68,"gross_charge":1108,"discounted_cash":642.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1052.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1063.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":808.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":919.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":808.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":531.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":384.26,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":354.56,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 FIRST 30 MINS","code_information":[{"code":"3936010130","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":5858.25,"maximum":7704,"gross_charge":8025,"discounted_cash":4654.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7623.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7704,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5858.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6660.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5858.25,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 FIRST 30 MINS","code_information":[{"code":"3936010130","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2568,"maximum":7704,"gross_charge":8025,"discounted_cash":4654.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7623.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7704,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5858.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6660.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5858.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3852,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2783.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2568,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 ADDL 15 MINS","code_information":[{"code":"3936010135","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1172.38,"maximum":1541.76,"gross_charge":1606,"discounted_cash":931.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1525.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1541.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1172.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1332.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1172.38,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 ADDL 15 MINS","code_information":[{"code":"3936010135","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":513.92,"maximum":1541.76,"gross_charge":1606,"discounted_cash":931.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1525.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1541.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1172.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1332.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1172.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":770.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":556.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":513.92,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 FIRST 30 MINS","code_information":[{"code":"3936010140","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":8494.28,"maximum":11170.56,"gross_charge":11636,"discounted_cash":6748.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11054.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11170.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8494.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9657.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8494.28,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 FIRST 30 MINS","code_information":[{"code":"3936010140","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":3723.52,"maximum":11170.56,"gross_charge":11636,"discounted_cash":6748.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11054.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11170.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8494.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9657.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8494.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5585.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":4035.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3723.52,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 ADDL 15 MINS","code_information":[{"code":"3936010145","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1699.44,"maximum":2234.88,"gross_charge":2328,"discounted_cash":1350.24,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2211.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2234.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1699.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1932.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1699.44,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 ADDL 15 MINS","code_information":[{"code":"3936010145","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":744.96,"maximum":2234.88,"gross_charge":2328,"discounted_cash":1350.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2211.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2234.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1699.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1932.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1699.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1117.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":807.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":744.96,"methodology":"fee schedule"}]}]},{"description":"TBNG CONN 60IN LONG","code_information":[{"code":"397252","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":75.19,"maximum":98.88,"gross_charge":103,"discounted_cash":59.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":97.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":98.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":75.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":85.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":75.19,"methodology":"fee schedule"}]}]},{"description":"TBNG CONN 60IN LONG","code_information":[{"code":"397252","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":32.96,"maximum":98.88,"gross_charge":103,"discounted_cash":59.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":97.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":98.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":75.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":85.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":75.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":49.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":35.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":32.96,"methodology":"fee schedule"}]}]},{"description":"TBNG CONN 120IN LONG","code_information":[{"code":"397254","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":90.52,"maximum":119.04,"gross_charge":124,"discounted_cash":71.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":117.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":102.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":90.52,"methodology":"fee schedule"}]}]},{"description":"TBNG CONN 120IN LONG","code_information":[{"code":"397254","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":39.68,"maximum":119.04,"gross_charge":124,"discounted_cash":71.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":117.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":102.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":43.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":39.68,"methodology":"fee schedule"}]}]},{"description":"DRSNG GAUZE X RAY 4X4","code_information":[{"code":"397610","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":0.73,"maximum":0.96,"gross_charge":1,"discounted_cash":0.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":0.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":0.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.73,"methodology":"fee schedule"}]}]},{"description":"DRSNG GAUZE X RAY 4X4","code_information":[{"code":"397610","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":0.32,"maximum":0.96,"gross_charge":1,"discounted_cash":0.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":0.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":0.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":0.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":0.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.32,"methodology":"fee schedule"}]}]},{"description":"TRAY JAMISHIDI SAFE T 11X4","code_information":[{"code":"397638","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":116.07,"maximum":152.64,"gross_charge":159,"discounted_cash":92.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":151.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.07,"methodology":"fee schedule"}]}]},{"description":"TRAY JAMISHIDI SAFE T 11X4","code_information":[{"code":"397638","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":50.88,"maximum":152.64,"gross_charge":159,"discounted_cash":92.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":151.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":55.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":50.88,"methodology":"fee schedule"}]}]},{"description":"PAD HEARTSTART AD CH PRE-CONN","code_information":[{"code":"397839","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":535.09,"maximum":703.68,"gross_charge":733,"discounted_cash":425.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":696.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":703.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":535.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":608.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":535.09,"methodology":"fee schedule"}]}]},{"description":"PAD HEARTSTART AD CH PRE-CONN","code_information":[{"code":"397839","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":234.56,"maximum":703.68,"gross_charge":733,"discounted_cash":425.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":696.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":703.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":535.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":608.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":535.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":351.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":254.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":234.56,"methodology":"fee schedule"}]}]},{"description":"ADRENAL PROCEDURES","code_information":[{"code":"4011","type":"APR-DRG"}],"standard_charges":[{"minimum":29088,"maximum":29088,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29088,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ADRENAL PROCEDURES","code_information":[{"code":"4012","type":"APR-DRG"}],"standard_charges":[{"minimum":59555,"maximum":59555,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":59555,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ADRENAL PROCEDURES","code_information":[{"code":"4013","type":"APR-DRG"}],"standard_charges":[{"minimum":74733,"maximum":74733,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":74733,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ADRENAL PROCEDURES","code_information":[{"code":"4014","type":"APR-DRG"}],"standard_charges":[{"minimum":125479,"maximum":125479,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":125479,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH CLSR FAST 3RD 60CM","code_information":[{"code":"401804","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2001.66,"maximum":2632.32,"gross_charge":2742,"discounted_cash":1590.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2604.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2632.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2001.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2275.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2001.66,"methodology":"fee schedule"}]}]},{"description":"CATH CLSR FAST 3RD 60CM","code_information":[{"code":"401804","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":877.44,"maximum":2632.32,"gross_charge":2742,"discounted_cash":1590.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2604.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2632.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2001.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2275.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2001.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1316.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":950.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":877.44,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC 3.2X245MM","code_information":[{"code":"401898","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":487.64,"maximum":641.28,"gross_charge":668,"discounted_cash":387.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":634.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":641.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":487.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":554.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":487.64,"methodology":"fee schedule"}]}]},{"description":"BIT DRL QC 3.2X245MM","code_information":[{"code":"401898","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":213.76,"maximum":641.28,"gross_charge":668,"discounted_cash":387.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":634.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":641.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":487.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":554.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":487.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":320.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":231.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":213.76,"methodology":"fee schedule"}]}]},{"description":"POUCH PEELABLE QUICKCLOT 4X4","code_information":[{"code":"402265","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":70.7,"maximum":92.97,"gross_charge":96.84,"discounted_cash":56.17,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":92.97,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":70.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":70.7,"methodology":"fee schedule"}]}]},{"description":"POUCH PEELABLE QUICKCLOT 4X4","code_information":[{"code":"402265","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":30.99,"maximum":92.97,"gross_charge":96.84,"discounted_cash":56.17,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":92.97,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":70.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":80.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":70.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":33.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":30.99,"methodology":"fee schedule"}]}]},{"description":"PROCEDURES FOR OBESITY","code_information":[{"code":"4031","type":"APR-DRG"}],"standard_charges":[{"minimum":26031,"maximum":26031,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26031,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PROCEDURES FOR OBESITY","code_information":[{"code":"4032","type":"APR-DRG"}],"standard_charges":[{"minimum":27701,"maximum":27701,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27701,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PROCEDURES FOR OBESITY","code_information":[{"code":"4033","type":"APR-DRG"}],"standard_charges":[{"minimum":41641,"maximum":41641,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41641,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PROCEDURES FOR OBESITY","code_information":[{"code":"4034","type":"APR-DRG"}],"standard_charges":[{"minimum":99343,"maximum":99343,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":99343,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INTRO ST MICRPUNC NDL 5FR 10CM","code_information":[{"code":"404046","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":105.85,"maximum":139.2,"gross_charge":145,"discounted_cash":84.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":137.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":139.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":105.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":120.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":105.85,"methodology":"fee schedule"}]}]},{"description":"INTRO ST MICRPUNC NDL 5FR 10CM","code_information":[{"code":"404046","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":46.4,"maximum":139.2,"gross_charge":145,"discounted_cash":84.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":137.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":139.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":105.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":120.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":105.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":69.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":50.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":46.4,"methodology":"fee schedule"}]}]},{"description":"THYROID PARATHYROID AND THYROGLOSSAL PROCEDURES","code_information":[{"code":"4041","type":"APR-DRG"}],"standard_charges":[{"minimum":17164,"maximum":17164,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17164,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"THYROID PARATHYROID AND THYROGLOSSAL PROCEDURES","code_information":[{"code":"4042","type":"APR-DRG"}],"standard_charges":[{"minimum":19459,"maximum":19459,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19459,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"THYROID PARATHYROID AND THYROGLOSSAL PROCEDURES","code_information":[{"code":"4043","type":"APR-DRG"}],"standard_charges":[{"minimum":61231,"maximum":61231,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":61231,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"THYROID PARATHYROID AND THYROGLOSSAL PROCEDURES","code_information":[{"code":"4044","type":"APR-DRG"}],"standard_charges":[{"minimum":123311,"maximum":123311,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":123311,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"WRAP NYLATEX 6X48","code_information":[{"code":"404752","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":130.67,"maximum":171.84,"gross_charge":179,"discounted_cash":103.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":170.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":171.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":130.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":148.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":130.67,"methodology":"fee schedule"}]}]},{"description":"WRAP NYLATEX 6X48","code_information":[{"code":"404752","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":57.28,"maximum":171.84,"gross_charge":179,"discounted_cash":103.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":170.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":171.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":130.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":148.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":130.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":62.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":57.28,"methodology":"fee schedule"}]}]},{"description":"STOCKINETTE TUBIGRIP SZ-B BGE","code_information":[{"code":"404958","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":177.39,"maximum":233.28,"gross_charge":243,"discounted_cash":140.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":230.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":233.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":177.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":201.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":177.39,"methodology":"fee schedule"}]}]},{"description":"STOCKINETTE TUBIGRIP SZ-B BGE","code_information":[{"code":"404958","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":77.76,"maximum":233.28,"gross_charge":243,"discounted_cash":140.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":230.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":233.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":177.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":201.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":177.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":116.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":84.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":77.76,"methodology":"fee schedule"}]}]},{"description":"OTHER PROCEDURES FOR ENDOCRINE NUTRITIONAL AND METABOLIC DISORDERS","code_information":[{"code":"4051","type":"APR-DRG"}],"standard_charges":[{"minimum":31977,"maximum":31977,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31977,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PROCEDURES FOR ENDOCRINE NUTRITIONAL AND METABOLIC DISORDERS","code_information":[{"code":"4052","type":"APR-DRG"}],"standard_charges":[{"minimum":36323,"maximum":36323,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36323,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PROCEDURES FOR ENDOCRINE NUTRITIONAL AND METABOLIC DISORDERS","code_information":[{"code":"4053","type":"APR-DRG"}],"standard_charges":[{"minimum":54750,"maximum":54750,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":54750,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PROCEDURES FOR ENDOCRINE NUTRITIONAL AND METABOLIC DISORDERS","code_information":[{"code":"4054","type":"APR-DRG"}],"standard_charges":[{"minimum":124170,"maximum":124170,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":124170,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BLDE MED NARW 25.0MMX5.5MM","code_information":[{"code":"405616","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":108.04,"maximum":142.08,"gross_charge":148,"discounted_cash":85.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":140.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.04,"methodology":"fee schedule"}]}]},{"description":"BLDE MED NARW 25.0MMX5.5MM","code_information":[{"code":"405616","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":47.36,"maximum":142.08,"gross_charge":148,"discounted_cash":85.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":140.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":51.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.36,"methodology":"fee schedule"}]}]},{"description":"DRSNG VAC GRANU SPIRAL MED","code_information":[{"code":"408432","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":140.16,"maximum":184.32,"gross_charge":192,"discounted_cash":111.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":182.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":184.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":140.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":159.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":140.16,"methodology":"fee schedule"}]}]},{"description":"DRSNG VAC GRANU SPIRAL MED","code_information":[{"code":"408432","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":61.44,"maximum":184.32,"gross_charge":192,"discounted_cash":111.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":182.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":184.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":140.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":159.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":92.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":66.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":61.44,"methodology":"fee schedule"}]}]},{"description":"END CAP 0 DEG","code_information":[{"code":"409718","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":297.11,"maximum":390.72,"gross_charge":407,"discounted_cash":236.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":386.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":390.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":297.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":337.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":297.11,"methodology":"fee schedule"}]}]},{"description":"END CAP 0 DEG","code_information":[{"code":"409718","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":130.24,"maximum":390.72,"gross_charge":407,"discounted_cash":236.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":386.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":390.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":297.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":337.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":297.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":195.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":141.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":130.24,"methodology":"fee schedule"}]}]},{"description":"PIN DISTR CERV 14MM","code_information":[{"code":"415861","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1854.2,"maximum":2438.4,"gross_charge":2540,"discounted_cash":1473.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2413,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2438.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1854.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2108.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1854.2,"methodology":"fee schedule"}]}]},{"description":"PIN DISTR CERV 14MM","code_information":[{"code":"415861","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":812.8,"maximum":2438.4,"gross_charge":2540,"discounted_cash":1473.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2413,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2438.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1854.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2108.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1854.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1219.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":880.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":812.8,"methodology":"fee schedule"}]}]},{"description":"TISS ADH OCTYLBOND","code_information":[{"code":"418822","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":46.72,"maximum":61.44,"gross_charge":64,"discounted_cash":37.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":60.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":61.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":46.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":53.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":46.72,"methodology":"fee schedule"}]}]},{"description":"TISS ADH OCTYLBOND","code_information":[{"code":"418822","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":20.48,"maximum":61.44,"gross_charge":64,"discounted_cash":37.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":60.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":61.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":46.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":53.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":46.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":30.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":22.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":20.48,"methodology":"fee schedule"}]}]},{"description":"DIABETES","code_information":[{"code":"4201","type":"APR-DRG"}],"standard_charges":[{"minimum":7544,"maximum":7544,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":7544,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIABETES","code_information":[{"code":"4202","type":"APR-DRG"}],"standard_charges":[{"minimum":11168,"maximum":11168,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11168,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIABETES","code_information":[{"code":"4203","type":"APR-DRG"}],"standard_charges":[{"minimum":18049,"maximum":18049,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18049,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIABETES","code_information":[{"code":"4204","type":"APR-DRG"}],"standard_charges":[{"minimum":39986,"maximum":39986,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":39986,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALNUTRITION FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS","code_information":[{"code":"4211","type":"APR-DRG"}],"standard_charges":[{"minimum":10209,"maximum":10209,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10209,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALNUTRITION FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS","code_information":[{"code":"4212","type":"APR-DRG"}],"standard_charges":[{"minimum":35312,"maximum":35312,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":35312,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALNUTRITION FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS","code_information":[{"code":"4213","type":"APR-DRG"}],"standard_charges":[{"minimum":45071,"maximum":45071,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45071,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALNUTRITION FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS","code_information":[{"code":"4214","type":"APR-DRG"}],"standard_charges":[{"minimum":46971,"maximum":46971,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46971,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS","code_information":[{"code":"4221","type":"APR-DRG"}],"standard_charges":[{"minimum":8422,"maximum":8422,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":8422,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS","code_information":[{"code":"4222","type":"APR-DRG"}],"standard_charges":[{"minimum":10487,"maximum":10487,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10487,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS","code_information":[{"code":"4223","type":"APR-DRG"}],"standard_charges":[{"minimum":23453,"maximum":23453,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23453,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS","code_information":[{"code":"4224","type":"APR-DRG"}],"standard_charges":[{"minimum":48015,"maximum":48015,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48015,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INBORN ERRORS OF METABOLISM","code_information":[{"code":"4231","type":"APR-DRG"}],"standard_charges":[{"minimum":11811,"maximum":11811,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11811,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INBORN ERRORS OF METABOLISM","code_information":[{"code":"4232","type":"APR-DRG"}],"standard_charges":[{"minimum":13122,"maximum":13122,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13122,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INBORN ERRORS OF METABOLISM","code_information":[{"code":"4233","type":"APR-DRG"}],"standard_charges":[{"minimum":26473,"maximum":26473,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26473,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INBORN ERRORS OF METABOLISM","code_information":[{"code":"4234","type":"APR-DRG"}],"standard_charges":[{"minimum":56267,"maximum":56267,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":56267,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ENDOCRINE DISORDERS","code_information":[{"code":"4241","type":"APR-DRG"}],"standard_charges":[{"minimum":11505,"maximum":11505,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11505,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ENDOCRINE DISORDERS","code_information":[{"code":"4242","type":"APR-DRG"}],"standard_charges":[{"minimum":16009,"maximum":16009,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16009,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ENDOCRINE DISORDERS","code_information":[{"code":"4243","type":"APR-DRG"}],"standard_charges":[{"minimum":23540,"maximum":23540,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23540,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ENDOCRINE DISORDERS","code_information":[{"code":"4244","type":"APR-DRG"}],"standard_charges":[{"minimum":41760,"maximum":41760,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41760,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS","code_information":[{"code":"4251","type":"APR-DRG"}],"standard_charges":[{"minimum":11546,"maximum":11546,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11546,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS","code_information":[{"code":"4252","type":"APR-DRG"}],"standard_charges":[{"minimum":13359,"maximum":13359,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13359,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS","code_information":[{"code":"4253","type":"APR-DRG"}],"standard_charges":[{"minimum":16577,"maximum":16577,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16577,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS","code_information":[{"code":"4254","type":"APR-DRG"}],"standard_charges":[{"minimum":45352,"maximum":45352,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45352,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-HYPOVOLEMIC SODIUM DISORDERS","code_information":[{"code":"4261","type":"APR-DRG"}],"standard_charges":[{"minimum":10800,"maximum":10800,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10800,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-HYPOVOLEMIC SODIUM DISORDERS","code_information":[{"code":"4262","type":"APR-DRG"}],"standard_charges":[{"minimum":14292,"maximum":14292,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14292,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-HYPOVOLEMIC SODIUM DISORDERS","code_information":[{"code":"4263","type":"APR-DRG"}],"standard_charges":[{"minimum":29529,"maximum":29529,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29529,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-HYPOVOLEMIC SODIUM DISORDERS","code_information":[{"code":"4264","type":"APR-DRG"}],"standard_charges":[{"minimum":38236,"maximum":38236,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38236,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BIT MILLING 2MM CYLINDRIC","code_information":[{"code":"426676","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":839.5,"maximum":1104,"gross_charge":1150,"discounted_cash":667,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1092.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1104,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":839.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":954.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":839.5,"methodology":"fee schedule"}]}]},{"description":"BIT MILLING 2MM CYLINDRIC","code_information":[{"code":"426676","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":368,"maximum":1104,"gross_charge":1150,"discounted_cash":667,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1092.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1104,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":839.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":954.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":839.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":552,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":398.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":368,"methodology":"fee schedule"}]}]},{"description":"THYROID DISORDERS","code_information":[{"code":"4271","type":"APR-DRG"}],"standard_charges":[{"minimum":10998,"maximum":10998,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10998,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"THYROID DISORDERS","code_information":[{"code":"4272","type":"APR-DRG"}],"standard_charges":[{"minimum":16129,"maximum":16129,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16129,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"THYROID DISORDERS","code_information":[{"code":"4273","type":"APR-DRG"}],"standard_charges":[{"minimum":22770,"maximum":22770,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22770,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"THYROID DISORDERS","code_information":[{"code":"4274","type":"APR-DRG"}],"standard_charges":[{"minimum":71657,"maximum":71657,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":71657,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH GASTSTMY COMPAT 24FR BLU","code_information":[{"code":"429792","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":45.99,"maximum":60.48,"gross_charge":63,"discounted_cash":36.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":59.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":60.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":45.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":52.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":45.99,"methodology":"fee schedule"}]}]},{"description":"CATH GASTSTMY COMPAT 24FR BLU","code_information":[{"code":"429792","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":20.16,"maximum":60.48,"gross_charge":63,"discounted_cash":36.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":59.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":60.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":45.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":52.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":45.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":30.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":21.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":20.16,"methodology":"fee schedule"}]}]},{"description":"TRACH QK CRICOTHYROTMY SET 2MM","code_information":[{"code":"431265","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":320.47,"maximum":421.44,"gross_charge":439,"discounted_cash":254.62,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":417.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":421.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":320.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":364.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":320.47,"methodology":"fee schedule"}]}]},{"description":"TRACH QK CRICOTHYROTMY SET 2MM","code_information":[{"code":"431265","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":140.48,"maximum":421.44,"gross_charge":439,"discounted_cash":254.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":417.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":421.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":320.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":364.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":320.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":210.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":152.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":140.48,"methodology":"fee schedule"}]}]},{"description":"PUMP E ENTRL FEEDG KANGAROO","code_information":[{"code":"431390","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":733.65,"maximum":964.8,"gross_charge":1005,"discounted_cash":582.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":954.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":964.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":733.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":834.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":733.65,"methodology":"fee schedule"}]}]},{"description":"PUMP E ENTRL FEEDG KANGAROO","code_information":[{"code":"431390","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":321.6,"maximum":964.8,"gross_charge":1005,"discounted_cash":582.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":954.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":964.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":733.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":834.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":733.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":482.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":348.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":321.6,"methodology":"fee schedule"}]}]},{"description":"COVER PRB US W/GEL 1.75X9.5IN","code_information":[{"code":"435571","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":5.11,"maximum":6.72,"gross_charge":7,"discounted_cash":4.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.11,"methodology":"fee schedule"}]}]},{"description":"COVER PRB US W/GEL 1.75X9.5IN","code_information":[{"code":"435571","type":"CDM"},{"code":"0271","type":"RC"}],"standard_charges":[{"minimum":2.24,"maximum":6.72,"gross_charge":7,"discounted_cash":4.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.24,"methodology":"fee schedule"}]}]},{"description":"BIT DRL FLEX 3.2","code_information":[{"code":"439143","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":709.56,"maximum":933.12,"gross_charge":972,"discounted_cash":563.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":923.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":933.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":709.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":806.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":709.56,"methodology":"fee schedule"}]}]},{"description":"BIT DRL FLEX 3.2","code_information":[{"code":"439143","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":311.04,"maximum":933.12,"gross_charge":972,"discounted_cash":563.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":923.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":933.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":709.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":806.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":709.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":466.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":337.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":311.04,"methodology":"fee schedule"}]}]},{"description":"KIDNEY TRANSPLANT","code_information":[{"code":"4401","type":"APR-DRG"}],"standard_charges":[{"minimum":113020,"maximum":113020,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":113020,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY TRANSPLANT","code_information":[{"code":"4402","type":"APR-DRG"}],"standard_charges":[{"minimum":231070,"maximum":231070,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":231070,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY TRANSPLANT","code_information":[{"code":"4403","type":"APR-DRG"}],"standard_charges":[{"minimum":269419,"maximum":269419,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":269419,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY TRANSPLANT","code_information":[{"code":"4404","type":"APR-DRG"}],"standard_charges":[{"minimum":408727,"maximum":408727,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":408727,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR BLADDER PROCEDURES","code_information":[{"code":"4411","type":"APR-DRG"}],"standard_charges":[{"minimum":35845,"maximum":35845,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":35845,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR BLADDER PROCEDURES","code_information":[{"code":"4412","type":"APR-DRG"}],"standard_charges":[{"minimum":47808,"maximum":47808,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":47808,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR BLADDER PROCEDURES","code_information":[{"code":"4413","type":"APR-DRG"}],"standard_charges":[{"minimum":66770,"maximum":66770,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":66770,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR BLADDER PROCEDURES","code_information":[{"code":"4414","type":"APR-DRG"}],"standard_charges":[{"minimum":150893,"maximum":150893,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":150893,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VEST SMARTVEST WRAP LG","code_information":[{"code":"442051","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":239.44,"maximum":314.88,"gross_charge":328,"discounted_cash":190.24,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":311.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":314.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":239.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":272.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":239.44,"methodology":"fee schedule"}]}]},{"description":"VEST SMARTVEST WRAP LG","code_information":[{"code":"442051","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":104.96,"maximum":314.88,"gross_charge":328,"discounted_cash":190.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":311.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":314.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":239.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":272.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":239.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":157.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":113.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":104.96,"methodology":"fee schedule"}]}]},{"description":"KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY","code_information":[{"code":"4421","type":"APR-DRG"}],"standard_charges":[{"minimum":33477,"maximum":33477,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33477,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY","code_information":[{"code":"4422","type":"APR-DRG"}],"standard_charges":[{"minimum":38875,"maximum":38875,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38875,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY","code_information":[{"code":"4423","type":"APR-DRG"}],"standard_charges":[{"minimum":49104,"maximum":49104,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":49104,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY","code_information":[{"code":"4424","type":"APR-DRG"}],"standard_charges":[{"minimum":112322,"maximum":112322,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":112322,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CATH KT SUPRPUB STAMEY 16FRX25","code_information":[{"code":"443027","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":119.72,"maximum":157.44,"gross_charge":164,"discounted_cash":95.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":155.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":157.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":119.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":136.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":119.72,"methodology":"fee schedule"}]}]},{"description":"CATH KT SUPRPUB STAMEY 16FRX25","code_information":[{"code":"443027","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":52.48,"maximum":157.44,"gross_charge":164,"discounted_cash":95.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":155.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":157.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":119.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":136.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":119.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":78.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":56.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":52.48,"methodology":"fee schedule"}]}]},{"description":"KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY","code_information":[{"code":"4431","type":"APR-DRG"}],"standard_charges":[{"minimum":23947,"maximum":23947,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23947,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY","code_information":[{"code":"4432","type":"APR-DRG"}],"standard_charges":[{"minimum":33025,"maximum":33025,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33025,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY","code_information":[{"code":"4433","type":"APR-DRG"}],"standard_charges":[{"minimum":50156,"maximum":50156,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50156,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"GAUZE XEROFORM CURAD 4X4","code_information":[{"code":"443383","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":2.59,"maximum":3.4,"gross_charge":3.54,"discounted_cash":2.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.59,"methodology":"fee schedule"}]}]},{"description":"GAUZE XEROFORM CURAD 4X4","code_information":[{"code":"443383","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":1.14,"maximum":3.4,"gross_charge":3.54,"discounted_cash":2.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.59,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1.14,"methodology":"fee schedule"}]}]},{"description":"KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY","code_information":[{"code":"4434","type":"APR-DRG"}],"standard_charges":[{"minimum":88058,"maximum":88058,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":88058,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PATCH IONTO SYS 80MA-MIN","code_information":[{"code":"443874","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":22.05,"maximum":29,"gross_charge":30.2,"discounted_cash":17.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":28.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":29,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":22.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":22.05,"methodology":"fee schedule"}]}]},{"description":"PATCH IONTO SYS 80MA-MIN","code_information":[{"code":"443874","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":9.67,"maximum":29,"gross_charge":30.2,"discounted_cash":17.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":28.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":29,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":22.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":25.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":22.05,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":14.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.67,"methodology":"fee schedule"}]}]},{"description":"RENAL DIALYSIS ACCESS DEVICE PROCEDURES AND VESSEL REPAIR","code_information":[{"code":"4441","type":"APR-DRG"}],"standard_charges":[{"minimum":23836,"maximum":23836,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23836,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RENAL DIALYSIS ACCESS DEVICE PROCEDURES AND VESSEL REPAIR","code_information":[{"code":"4442","type":"APR-DRG"}],"standard_charges":[{"minimum":35543,"maximum":35543,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":35543,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RENAL DIALYSIS ACCESS DEVICE PROCEDURES AND VESSEL REPAIR","code_information":[{"code":"4443","type":"APR-DRG"}],"standard_charges":[{"minimum":46298,"maximum":46298,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46298,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RENAL DIALYSIS ACCESS DEVICE PROCEDURES AND VESSEL REPAIR","code_information":[{"code":"4444","type":"APR-DRG"}],"standard_charges":[{"minimum":83901,"maximum":83901,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":83901,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER BLADDER PROCEDURES","code_information":[{"code":"4451","type":"APR-DRG"}],"standard_charges":[{"minimum":24149,"maximum":24149,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24149,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER BLADDER PROCEDURES","code_information":[{"code":"4452","type":"APR-DRG"}],"standard_charges":[{"minimum":32290,"maximum":32290,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32290,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER BLADDER PROCEDURES","code_information":[{"code":"4453","type":"APR-DRG"}],"standard_charges":[{"minimum":45728,"maximum":45728,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45728,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER BLADDER PROCEDURES","code_information":[{"code":"4454","type":"APR-DRG"}],"standard_charges":[{"minimum":82740,"maximum":82740,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":82740,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"URETHRAL AND TRANSURETHRAL PROCEDURES","code_information":[{"code":"4461","type":"APR-DRG"}],"standard_charges":[{"minimum":14616,"maximum":14616,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14616,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"URETHRAL AND TRANSURETHRAL PROCEDURES","code_information":[{"code":"4462","type":"APR-DRG"}],"standard_charges":[{"minimum":17799,"maximum":17799,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17799,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"URETHRAL AND TRANSURETHRAL PROCEDURES","code_information":[{"code":"4463","type":"APR-DRG"}],"standard_charges":[{"minimum":37754,"maximum":37754,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37754,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"URETHRAL AND TRANSURETHRAL PROCEDURES","code_information":[{"code":"4464","type":"APR-DRG"}],"standard_charges":[{"minimum":68090,"maximum":68090,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":68090,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER KIDNEY URINARY TRACT AND RELATED PROCEDURES","code_information":[{"code":"4471","type":"APR-DRG"}],"standard_charges":[{"minimum":32345,"maximum":32345,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32345,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER KIDNEY URINARY TRACT AND RELATED PROCEDURES","code_information":[{"code":"4472","type":"APR-DRG"}],"standard_charges":[{"minimum":40162,"maximum":40162,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":40162,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER KIDNEY URINARY TRACT AND RELATED PROCEDURES","code_information":[{"code":"4473","type":"APR-DRG"}],"standard_charges":[{"minimum":61496,"maximum":61496,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":61496,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER KIDNEY URINARY TRACT AND RELATED PROCEDURES","code_information":[{"code":"4474","type":"APR-DRG"}],"standard_charges":[{"minimum":107504,"maximum":107504,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":107504,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BLDE LARYNSCP FBOPT MAC 4 DISP","code_information":[{"code":"457321","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":20.43,"maximum":26.87,"gross_charge":27.98,"discounted_cash":16.23,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":26.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":26.87,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":20.43,"methodology":"fee schedule"}]}]},{"description":"BLDE LARYNSCP FBOPT MAC 4 DISP","code_information":[{"code":"457321","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":8.96,"maximum":26.87,"gross_charge":27.98,"discounted_cash":16.23,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":26.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":26.87,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":20.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":23.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":20.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":13.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.96,"methodology":"fee schedule"}]}]},{"description":"KIDNEY AND URINARY TRACT MALIGNANCY","code_information":[{"code":"4611","type":"APR-DRG"}],"standard_charges":[{"minimum":15972,"maximum":15972,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15972,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT MALIGNANCY","code_information":[{"code":"4612","type":"APR-DRG"}],"standard_charges":[{"minimum":22410,"maximum":22410,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22410,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT MALIGNANCY","code_information":[{"code":"4613","type":"APR-DRG"}],"standard_charges":[{"minimum":32384,"maximum":32384,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32384,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT MALIGNANCY","code_information":[{"code":"4614","type":"APR-DRG"}],"standard_charges":[{"minimum":40360,"maximum":40360,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":40360,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEPHRITIS AND NEPHROSIS","code_information":[{"code":"4621","type":"APR-DRG"}],"standard_charges":[{"minimum":10924,"maximum":10924,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10924,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEPHRITIS AND NEPHROSIS","code_information":[{"code":"4622","type":"APR-DRG"}],"standard_charges":[{"minimum":14877,"maximum":14877,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14877,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEPHRITIS AND NEPHROSIS","code_information":[{"code":"4623","type":"APR-DRG"}],"standard_charges":[{"minimum":22349,"maximum":22349,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22349,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEPHRITIS AND NEPHROSIS","code_information":[{"code":"4624","type":"APR-DRG"}],"standard_charges":[{"minimum":63992,"maximum":63992,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":63992,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT INFECTIONS","code_information":[{"code":"4631","type":"APR-DRG"}],"standard_charges":[{"minimum":10757,"maximum":10757,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10757,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT INFECTIONS","code_information":[{"code":"4632","type":"APR-DRG"}],"standard_charges":[{"minimum":13346,"maximum":13346,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13346,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT INFECTIONS","code_information":[{"code":"4633","type":"APR-DRG"}],"standard_charges":[{"minimum":22938,"maximum":22938,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22938,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KIDNEY AND URINARY TRACT INFECTIONS","code_information":[{"code":"4634","type":"APR-DRG"}],"standard_charges":[{"minimum":41752,"maximum":41752,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41752,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIV/SEALER LIGASURE 5MM","code_information":[{"code":"464114","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":617.58,"maximum":812.16,"gross_charge":846,"discounted_cash":490.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":803.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":812.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":617.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":702.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":617.58,"methodology":"fee schedule"}]}]},{"description":"DIV/SEALER LIGASURE 5MM","code_information":[{"code":"464114","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":270.72,"maximum":812.16,"gross_charge":846,"discounted_cash":490.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":803.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":812.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":617.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":702.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":617.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":406.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":293.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":270.72,"methodology":"fee schedule"}]}]},{"description":"URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION","code_information":[{"code":"4651","type":"APR-DRG"}],"standard_charges":[{"minimum":12561,"maximum":12561,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12561,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION","code_information":[{"code":"4652","type":"APR-DRG"}],"standard_charges":[{"minimum":12714,"maximum":12714,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12714,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION","code_information":[{"code":"4653","type":"APR-DRG"}],"standard_charges":[{"minimum":17659,"maximum":17659,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17659,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION","code_information":[{"code":"4654","type":"APR-DRG"}],"standard_charges":[{"minimum":41363,"maximum":41363,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41363,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE","code_information":[{"code":"4661","type":"APR-DRG"}],"standard_charges":[{"minimum":10894,"maximum":10894,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10894,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE","code_information":[{"code":"4662","type":"APR-DRG"}],"standard_charges":[{"minimum":12029,"maximum":12029,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12029,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE","code_information":[{"code":"4663","type":"APR-DRG"}],"standard_charges":[{"minimum":23647,"maximum":23647,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23647,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALFUNCTION REACTION COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE","code_information":[{"code":"4664","type":"APR-DRG"}],"standard_charges":[{"minimum":46604,"maximum":46604,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46604,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER KIDNEY AND URINARY TRACT DIAGNOSES SIGNS AND SYMPTOMS","code_information":[{"code":"4681","type":"APR-DRG"}],"standard_charges":[{"minimum":11594,"maximum":11594,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11594,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER KIDNEY AND URINARY TRACT DIAGNOSES SIGNS AND SYMPTOMS","code_information":[{"code":"4682","type":"APR-DRG"}],"standard_charges":[{"minimum":17957,"maximum":17957,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17957,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER KIDNEY AND URINARY TRACT DIAGNOSES SIGNS AND SYMPTOMS","code_information":[{"code":"4683","type":"APR-DRG"}],"standard_charges":[{"minimum":25131,"maximum":25131,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25131,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER KIDNEY AND URINARY TRACT DIAGNOSES SIGNS AND SYMPTOMS","code_information":[{"code":"4684","type":"APR-DRG"}],"standard_charges":[{"minimum":37962,"maximum":37962,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37962,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE KIDNEY INJURY","code_information":[{"code":"4691","type":"APR-DRG"}],"standard_charges":[{"minimum":9694,"maximum":9694,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9694,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE KIDNEY INJURY","code_information":[{"code":"4692","type":"APR-DRG"}],"standard_charges":[{"minimum":14044,"maximum":14044,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14044,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE KIDNEY INJURY","code_information":[{"code":"4693","type":"APR-DRG"}],"standard_charges":[{"minimum":28777,"maximum":28777,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28777,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE KIDNEY INJURY","code_information":[{"code":"4694","type":"APR-DRG"}],"standard_charges":[{"minimum":77447,"maximum":77447,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":77447,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHRONIC KIDNEY DISEASE","code_information":[{"code":"4701","type":"APR-DRG"}],"standard_charges":[{"minimum":10050,"maximum":10050,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10050,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHRONIC KIDNEY DISEASE","code_information":[{"code":"4702","type":"APR-DRG"}],"standard_charges":[{"minimum":15109,"maximum":15109,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15109,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHRONIC KIDNEY DISEASE","code_information":[{"code":"4703","type":"APR-DRG"}],"standard_charges":[{"minimum":19027,"maximum":19027,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19027,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHRONIC KIDNEY DISEASE","code_information":[{"code":"4704","type":"APR-DRG"}],"standard_charges":[{"minimum":36682,"maximum":36682,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36682,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INJ BIL DRAIN W/GUIDE EXIST","code_information":[{"code":"47531","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":6310.12,"maximum":8298.24,"gross_charge":8644,"discounted_cash":5013.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8211.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8298.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6310.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7174.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6310.12,"methodology":"fee schedule"}]}]},{"description":"INJ BIL DRAIN W/GUIDE EXIST","code_information":[{"code":"47531","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":2766.08,"maximum":8298.24,"gross_charge":8644,"discounted_cash":5013.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8211.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8298.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6310.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7174.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6310.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4149.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2997.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2766.08,"methodology":"fee schedule"}]}]},{"description":"REMOVAL BILI STONE W/GUID S&I","code_information":[{"code":"47544","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":6326.91,"maximum":8320.32,"gross_charge":8667,"discounted_cash":5026.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8233.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8320.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6326.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7193.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6326.91,"methodology":"fee schedule"}]}]},{"description":"REMOVAL BILI STONE W/GUID S&I","code_information":[{"code":"47544","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":2773.44,"maximum":8320.32,"gross_charge":8667,"discounted_cash":5026.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":8233.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":8320.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":6326.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":7193.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":6326.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":4160.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3005.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2773.44,"methodology":"fee schedule"}]}]},{"description":"KT TRACH PORTEX PERFIT 7MM","code_information":[{"code":"475911","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":821.25,"maximum":1080,"gross_charge":1125,"discounted_cash":652.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1068.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1080,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":821.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":933.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":821.25,"methodology":"fee schedule"}]}]},{"description":"KT TRACH PORTEX PERFIT 7MM","code_information":[{"code":"475911","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":360,"maximum":1080,"gross_charge":1125,"discounted_cash":652.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1068.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1080,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":821.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":933.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":821.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":540,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":390.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":360,"methodology":"fee schedule"}]}]},{"description":"BLOCK AXILLARY","code_information":[{"code":"480000001","type":"CDM"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":391.28,"maximum":514.56,"gross_charge":536,"discounted_cash":310.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":509.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":514.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":391.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":444.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":391.28,"methodology":"fee schedule"}]}]},{"description":"BLOCK AXILLARY","code_information":[{"code":"480000001","type":"CDM"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":171.52,"maximum":514.56,"gross_charge":536,"discounted_cash":310.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":509.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":514.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":391.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":444.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":391.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":257.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":185.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":171.52,"methodology":"fee schedule"}]}]},{"description":"GENERAL ANESTHESIA","code_information":[{"code":"480000009","type":"CDM"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":16.79,"maximum":22.08,"gross_charge":23,"discounted_cash":13.34,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":21.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.79,"methodology":"fee schedule"}]}]},{"description":"GENERAL ANESTHESIA","code_information":[{"code":"480000009","type":"CDM"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":7.36,"maximum":22.08,"gross_charge":23,"discounted_cash":13.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":21.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":11.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.36,"methodology":"fee schedule"}]}]},{"description":"MONITORED ANESTHESIA CARE MAC","code_information":[{"code":"480000016","type":"CDM"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":13.14,"maximum":17.28,"gross_charge":18,"discounted_cash":10.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":17.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":17.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.14,"methodology":"fee schedule"}]}]},{"description":"MONITORED ANESTHESIA CARE MAC","code_information":[{"code":"480000016","type":"CDM"},{"code":"0370","type":"RC"}],"standard_charges":[{"minimum":5.76,"maximum":17.28,"gross_charge":18,"discounted_cash":10.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":17.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":17.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":14.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":13.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":8.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.76,"methodology":"fee schedule"}]}]},{"description":"GEN ANESTHESIA FOR RAD","code_information":[{"code":"480000022","type":"CDM"},{"code":"0371","type":"RC"}],"standard_charges":[{"minimum":16.79,"maximum":22.08,"gross_charge":23,"discounted_cash":13.34,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":21.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.79,"methodology":"fee schedule"}]}]},{"description":"GEN ANESTHESIA FOR RAD","code_information":[{"code":"480000022","type":"CDM"},{"code":"0371","type":"RC"}],"standard_charges":[{"minimum":7.36,"maximum":22.08,"gross_charge":23,"discounted_cash":13.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":21.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":11.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.36,"methodology":"fee schedule"}]}]},{"description":"MAJOR MALE PELVIC PROCEDURES","code_information":[{"code":"4801","type":"APR-DRG"}],"standard_charges":[{"minimum":29216,"maximum":29216,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29216,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR MALE PELVIC PROCEDURES","code_information":[{"code":"4802","type":"APR-DRG"}],"standard_charges":[{"minimum":34140,"maximum":34140,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34140,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR MALE PELVIC PROCEDURES","code_information":[{"code":"4803","type":"APR-DRG"}],"standard_charges":[{"minimum":58015,"maximum":58015,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":58015,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR MALE PELVIC PROCEDURES","code_information":[{"code":"4804","type":"APR-DRG"}],"standard_charges":[{"minimum":95286,"maximum":95286,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":95286,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRANSURETHRAL PROSTATECTOMY","code_information":[{"code":"4821","type":"APR-DRG"}],"standard_charges":[{"minimum":18636,"maximum":18636,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18636,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRANSURETHRAL PROSTATECTOMY","code_information":[{"code":"4822","type":"APR-DRG"}],"standard_charges":[{"minimum":21899,"maximum":21899,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21899,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRANSURETHRAL PROSTATECTOMY","code_information":[{"code":"4823","type":"APR-DRG"}],"standard_charges":[{"minimum":41449,"maximum":41449,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41449,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TRANSURETHRAL PROSTATECTOMY","code_information":[{"code":"4824","type":"APR-DRG"}],"standard_charges":[{"minimum":68974,"maximum":68974,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":68974,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PENIS TESTES AND SCROTAL PROCEDURES","code_information":[{"code":"4831","type":"APR-DRG"}],"standard_charges":[{"minimum":26410,"maximum":26410,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26410,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PENIS TESTES AND SCROTAL PROCEDURES","code_information":[{"code":"4832","type":"APR-DRG"}],"standard_charges":[{"minimum":29779,"maximum":29779,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29779,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PENIS TESTES AND SCROTAL PROCEDURES","code_information":[{"code":"4833","type":"APR-DRG"}],"standard_charges":[{"minimum":48180,"maximum":48180,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48180,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PENIS TESTES AND SCROTAL PROCEDURES","code_information":[{"code":"4834","type":"APR-DRG"}],"standard_charges":[{"minimum":86951,"maximum":86951,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":86951,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"4841","type":"APR-DRG"}],"standard_charges":[{"minimum":28586,"maximum":28586,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28586,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"4842","type":"APR-DRG"}],"standard_charges":[{"minimum":33264,"maximum":33264,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33264,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"4843","type":"APR-DRG"}],"standard_charges":[{"minimum":47643,"maximum":47643,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":47643,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"4844","type":"APR-DRG"}],"standard_charges":[{"minimum":96647,"maximum":96647,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":96647,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"APPLIER LIG ENDOSCP MEDLG 10MX","code_information":[{"code":"489275","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":103.66,"maximum":136.32,"gross_charge":142,"discounted_cash":82.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":134.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":136.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":103.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":117.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":103.66,"methodology":"fee schedule"}]}]},{"description":"APPLIER LIG ENDOSCP MEDLG 10MX","code_information":[{"code":"489275","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":45.44,"maximum":136.32,"gross_charge":142,"discounted_cash":82.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":134.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":136.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":103.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":117.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":103.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":49.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":45.44,"methodology":"fee schedule"}]}]},{"description":"MALIGNANCY MALE REPRODUCTIVE SYSTEM","code_information":[{"code":"5001","type":"APR-DRG"}],"standard_charges":[{"minimum":12827,"maximum":12827,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12827,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALIGNANCY MALE REPRODUCTIVE SYSTEM","code_information":[{"code":"5002","type":"APR-DRG"}],"standard_charges":[{"minimum":17579,"maximum":17579,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17579,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALIGNANCY MALE REPRODUCTIVE SYSTEM","code_information":[{"code":"5003","type":"APR-DRG"}],"standard_charges":[{"minimum":25260,"maximum":25260,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25260,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALIGNANCY MALE REPRODUCTIVE SYSTEM","code_information":[{"code":"5004","type":"APR-DRG"}],"standard_charges":[{"minimum":48152,"maximum":48152,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48152,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY","code_information":[{"code":"5011","type":"APR-DRG"}],"standard_charges":[{"minimum":12461,"maximum":12461,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12461,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY","code_information":[{"code":"5012","type":"APR-DRG"}],"standard_charges":[{"minimum":19438,"maximum":19438,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19438,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY","code_information":[{"code":"5013","type":"APR-DRG"}],"standard_charges":[{"minimum":28536,"maximum":28536,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28536,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY","code_information":[{"code":"5014","type":"APR-DRG"}],"standard_charges":[{"minimum":46930,"maximum":46930,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46930,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PATCH ACTIVA DRUG DELIV SYS","code_information":[{"code":"505316","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":27.96,"maximum":36.77,"gross_charge":38.3,"discounted_cash":22.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":36.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":36.77,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":27.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":27.96,"methodology":"fee schedule"}]}]},{"description":"PATCH ACTIVA DRUG DELIV SYS","code_information":[{"code":"505316","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":12.26,"maximum":36.77,"gross_charge":38.3,"discounted_cash":22.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":36.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":36.77,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":27.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":27.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":18.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":12.26,"methodology":"fee schedule"}]}]},{"description":"PELVIC EVISCERATION RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES","code_information":[{"code":"5101","type":"APR-DRG"}],"standard_charges":[{"minimum":34906,"maximum":34906,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34906,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PELVIC EVISCERATION RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES","code_information":[{"code":"5102","type":"APR-DRG"}],"standard_charges":[{"minimum":40847,"maximum":40847,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":40847,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PELVIC EVISCERATION RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES","code_information":[{"code":"5103","type":"APR-DRG"}],"standard_charges":[{"minimum":62257,"maximum":62257,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":62257,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PELVIC EVISCERATION RADICAL HYSTERECTOMY AND OTHER RADICAL GYNECOLOGICAL PROCEDURES","code_information":[{"code":"5104","type":"APR-DRG"}],"standard_charges":[{"minimum":128077,"maximum":128077,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":128077,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LARYNSCP HNDL BRTPRO SOLO DISP","code_information":[{"code":"510843","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":21.36,"maximum":28.08,"gross_charge":29.25,"discounted_cash":16.97,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":28.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.36,"methodology":"fee schedule"}]}]},{"description":"LARYNSCP HNDL BRTPRO SOLO DISP","code_information":[{"code":"510843","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":9.36,"maximum":28.08,"gross_charge":29.25,"discounted_cash":16.97,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":28.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":14.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.36,"methodology":"fee schedule"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY","code_information":[{"code":"5111","type":"APR-DRG"}],"standard_charges":[{"minimum":35099,"maximum":35099,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":35099,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY","code_information":[{"code":"5112","type":"APR-DRG"}],"standard_charges":[{"minimum":42089,"maximum":42089,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":42089,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY","code_information":[{"code":"5113","type":"APR-DRG"}],"standard_charges":[{"minimum":62776,"maximum":62776,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":62776,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY","code_information":[{"code":"5114","type":"APR-DRG"}],"standard_charges":[{"minimum":115620,"maximum":115620,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":115620,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY","code_information":[{"code":"5121","type":"APR-DRG"}],"standard_charges":[{"minimum":32184,"maximum":32184,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32184,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY","code_information":[{"code":"5122","type":"APR-DRG"}],"standard_charges":[{"minimum":38078,"maximum":38078,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38078,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY","code_information":[{"code":"5123","type":"APR-DRG"}],"standard_charges":[{"minimum":61335,"maximum":61335,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":61335,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY","code_information":[{"code":"5124","type":"APR-DRG"}],"standard_charges":[{"minimum":102669,"maximum":102669,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":102669,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA","code_information":[{"code":"5131","type":"APR-DRG"}],"standard_charges":[{"minimum":16694,"maximum":16694,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16694,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA","code_information":[{"code":"5132","type":"APR-DRG"}],"standard_charges":[{"minimum":20099,"maximum":20099,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20099,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA","code_information":[{"code":"5133","type":"APR-DRG"}],"standard_charges":[{"minimum":44917,"maximum":44917,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44917,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA","code_information":[{"code":"5134","type":"APR-DRG"}],"standard_charges":[{"minimum":77186,"maximum":77186,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":77186,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES","code_information":[{"code":"5141","type":"APR-DRG"}],"standard_charges":[{"minimum":20486,"maximum":20486,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20486,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES","code_information":[{"code":"5142","type":"APR-DRG"}],"standard_charges":[{"minimum":27808,"maximum":27808,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27808,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES","code_information":[{"code":"5143","type":"APR-DRG"}],"standard_charges":[{"minimum":58968,"maximum":58968,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":58968,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES","code_information":[{"code":"5144","type":"APR-DRG"}],"standard_charges":[{"minimum":98556,"maximum":98556,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":98556,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES","code_information":[{"code":"5171","type":"APR-DRG"}],"standard_charges":[{"minimum":17392,"maximum":17392,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17392,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES","code_information":[{"code":"5172","type":"APR-DRG"}],"standard_charges":[{"minimum":24092,"maximum":24092,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24092,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES","code_information":[{"code":"5173","type":"APR-DRG"}],"standard_charges":[{"minimum":37056,"maximum":37056,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37056,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES","code_information":[{"code":"5174","type":"APR-DRG"}],"standard_charges":[{"minimum":65181,"maximum":65181,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":65181,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"5181","type":"APR-DRG"}],"standard_charges":[{"minimum":23357,"maximum":23357,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23357,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"5182","type":"APR-DRG"}],"standard_charges":[{"minimum":36495,"maximum":36495,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36495,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"5183","type":"APR-DRG"}],"standard_charges":[{"minimum":49817,"maximum":49817,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":49817,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES","code_information":[{"code":"5184","type":"APR-DRG"}],"standard_charges":[{"minimum":94565,"maximum":94565,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":94565,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA","code_information":[{"code":"5191","type":"APR-DRG"}],"standard_charges":[{"minimum":18505,"maximum":18505,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18505,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA","code_information":[{"code":"5192","type":"APR-DRG"}],"standard_charges":[{"minimum":19659,"maximum":19659,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19659,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA","code_information":[{"code":"5193","type":"APR-DRG"}],"standard_charges":[{"minimum":46578,"maximum":46578,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46578,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA","code_information":[{"code":"5194","type":"APR-DRG"}],"standard_charges":[{"minimum":92406,"maximum":92406,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":92406,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM MALIGNANCY","code_information":[{"code":"5301","type":"APR-DRG"}],"standard_charges":[{"minimum":13816,"maximum":13816,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13816,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM MALIGNANCY","code_information":[{"code":"5302","type":"APR-DRG"}],"standard_charges":[{"minimum":17609,"maximum":17609,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17609,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM MALIGNANCY","code_information":[{"code":"5303","type":"APR-DRG"}],"standard_charges":[{"minimum":31751,"maximum":31751,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31751,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM MALIGNANCY","code_information":[{"code":"5304","type":"APR-DRG"}],"standard_charges":[{"minimum":43530,"maximum":43530,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43530,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM INFECTIONS","code_information":[{"code":"5311","type":"APR-DRG"}],"standard_charges":[{"minimum":11768,"maximum":11768,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11768,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM INFECTIONS","code_information":[{"code":"5312","type":"APR-DRG"}],"standard_charges":[{"minimum":15735,"maximum":15735,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15735,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM INFECTIONS","code_information":[{"code":"5313","type":"APR-DRG"}],"standard_charges":[{"minimum":23760,"maximum":23760,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23760,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEMALE REPRODUCTIVE SYSTEM INFECTIONS","code_information":[{"code":"5314","type":"APR-DRG"}],"standard_charges":[{"minimum":41739,"maximum":41739,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41739,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS","code_information":[{"code":"5321","type":"APR-DRG"}],"standard_charges":[{"minimum":10420,"maximum":10420,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10420,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS","code_information":[{"code":"5322","type":"APR-DRG"}],"standard_charges":[{"minimum":13137,"maximum":13137,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13137,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS","code_information":[{"code":"5323","type":"APR-DRG"}],"standard_charges":[{"minimum":20396,"maximum":20396,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20396,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS","code_information":[{"code":"5324","type":"APR-DRG"}],"standard_charges":[{"minimum":34399,"maximum":34399,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34399,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"HANDL LARYNGOSCOPE MAC 2","code_information":[{"code":"535834","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":34.94,"maximum":45.95,"gross_charge":47.86,"discounted_cash":27.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":45.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":45.95,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":34.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":34.94,"methodology":"fee schedule"}]}]},{"description":"HANDL LARYNGOSCOPE MAC 2","code_information":[{"code":"535834","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":15.32,"maximum":45.95,"gross_charge":47.86,"discounted_cash":27.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":45.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":45.95,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":34.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":39.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":34.94,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":22.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":15.32,"methodology":"fee schedule"}]}]},{"description":"TY THORCNTS PRCNTS 8FR 4.75IN","code_information":[{"code":"536710","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":68.62,"maximum":90.24,"gross_charge":94,"discounted_cash":54.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":89.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":90.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":68.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":78.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":68.62,"methodology":"fee schedule"}]}]},{"description":"TY THORCNTS PRCNTS 8FR 4.75IN","code_information":[{"code":"536710","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":30.08,"maximum":90.24,"gross_charge":94,"discounted_cash":54.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":89.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":90.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":68.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":78.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":68.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":45.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":30.08,"methodology":"fee schedule"}]}]},{"description":"BONE MARROW BIOPSY TRAY","code_information":[{"code":"536719","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":72.27,"maximum":95.04,"gross_charge":99,"discounted_cash":57.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":94.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":95.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":72.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":82.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":72.27,"methodology":"fee schedule"}]}]},{"description":"BONE MARROW BIOPSY TRAY","code_information":[{"code":"536719","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":31.68,"maximum":95.04,"gross_charge":99,"discounted_cash":57.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":94.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":95.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":72.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":82.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":72.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":47.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":34.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":31.68,"methodology":"fee schedule"}]}]},{"description":"CESAREAN SECTION WITH STERILIZATION","code_information":[{"code":"5391","type":"APR-DRG"}],"standard_charges":[{"minimum":12683,"maximum":12683,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12683,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CESAREAN SECTION WITH STERILIZATION","code_information":[{"code":"5392","type":"APR-DRG"}],"standard_charges":[{"minimum":18855,"maximum":18855,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18855,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CESAREAN SECTION WITH STERILIZATION","code_information":[{"code":"5393","type":"APR-DRG"}],"standard_charges":[{"minimum":20168,"maximum":20168,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20168,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CESAREAN SECTION WITH STERILIZATION","code_information":[{"code":"5394","type":"APR-DRG"}],"standard_charges":[{"minimum":53089,"maximum":53089,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":53089,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CESAREAN SECTION WITHOUT STERILIZATION","code_information":[{"code":"5401","type":"APR-DRG"}],"standard_charges":[{"minimum":14042,"maximum":14042,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14042,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CESAREAN SECTION WITHOUT STERILIZATION","code_information":[{"code":"5402","type":"APR-DRG"}],"standard_charges":[{"minimum":17659,"maximum":17659,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17659,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CESAREAN SECTION WITHOUT STERILIZATION","code_information":[{"code":"5403","type":"APR-DRG"}],"standard_charges":[{"minimum":24966,"maximum":24966,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24966,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CESAREAN SECTION WITHOUT STERILIZATION","code_information":[{"code":"5404","type":"APR-DRG"}],"standard_charges":[{"minimum":38934,"maximum":38934,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38934,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C","code_information":[{"code":"5411","type":"APR-DRG"}],"standard_charges":[{"minimum":13977,"maximum":13977,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13977,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C","code_information":[{"code":"5412","type":"APR-DRG"}],"standard_charges":[{"minimum":16268,"maximum":16268,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16268,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C","code_information":[{"code":"5413","type":"APR-DRG"}],"standard_charges":[{"minimum":19114,"maximum":19114,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19114,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C","code_information":[{"code":"5414","type":"APR-DRG"}],"standard_charges":[{"minimum":27618,"maximum":27618,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27618,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C","code_information":[{"code":"5421","type":"APR-DRG"}],"standard_charges":[{"minimum":9333,"maximum":9333,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9333,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C","code_information":[{"code":"5422","type":"APR-DRG"}],"standard_charges":[{"minimum":11900,"maximum":11900,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11900,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C","code_information":[{"code":"5423","type":"APR-DRG"}],"standard_charges":[{"minimum":18003,"maximum":18003,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18003,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C","code_information":[{"code":"5424","type":"APR-DRG"}],"standard_charges":[{"minimum":19803,"maximum":19803,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19803,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABORTION WITH D&C ASPIRATION CURETTAGE OR HYSTEROTOMY","code_information":[{"code":"5431","type":"APR-DRG"}],"standard_charges":[{"minimum":13111,"maximum":13111,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13111,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABORTION WITH D&C ASPIRATION CURETTAGE OR HYSTEROTOMY","code_information":[{"code":"5432","type":"APR-DRG"}],"standard_charges":[{"minimum":15105,"maximum":15105,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15105,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABORTION WITH D&C ASPIRATION CURETTAGE OR HYSTEROTOMY","code_information":[{"code":"5433","type":"APR-DRG"}],"standard_charges":[{"minimum":21960,"maximum":21960,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21960,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABORTION WITH D&C ASPIRATION CURETTAGE OR HYSTEROTOMY","code_information":[{"code":"5434","type":"APR-DRG"}],"standard_charges":[{"minimum":59605,"maximum":59605,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":59605,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANTEPARTUM WITH O.R. PROCEDURE","code_information":[{"code":"5471","type":"APR-DRG"}],"standard_charges":[{"minimum":13194,"maximum":13194,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13194,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANTEPARTUM WITH O.R. PROCEDURE","code_information":[{"code":"5472","type":"APR-DRG"}],"standard_charges":[{"minimum":24490,"maximum":24490,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24490,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANTEPARTUM WITH O.R. PROCEDURE","code_information":[{"code":"5473","type":"APR-DRG"}],"standard_charges":[{"minimum":27779,"maximum":27779,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27779,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANTEPARTUM WITH O.R. PROCEDURE","code_information":[{"code":"5474","type":"APR-DRG"}],"standard_charges":[{"minimum":58587,"maximum":58587,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":58587,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE","code_information":[{"code":"5481","type":"APR-DRG"}],"standard_charges":[{"minimum":10644,"maximum":10644,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10644,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE","code_information":[{"code":"5482","type":"APR-DRG"}],"standard_charges":[{"minimum":15838,"maximum":15838,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15838,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE","code_information":[{"code":"5483","type":"APR-DRG"}],"standard_charges":[{"minimum":32197,"maximum":32197,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32197,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE","code_information":[{"code":"5484","type":"APR-DRG"}],"standard_charges":[{"minimum":75077,"maximum":75077,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":75077,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TY CATH TEMP SENSE 16FR 5CC","code_information":[{"code":"558564","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":60.89,"maximum":80.08,"gross_charge":83.41,"discounted_cash":48.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":79.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":80.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":60.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":69.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":60.89,"methodology":"fee schedule"}]}]},{"description":"TY CATH TEMP SENSE 16FR 5CC","code_information":[{"code":"558564","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":26.7,"maximum":80.08,"gross_charge":83.41,"discounted_cash":48.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":79.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":80.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":60.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":69.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":60.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":40.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":28.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":26.7,"methodology":"fee schedule"}]}]},{"description":"VAGINAL DELIVERY","code_information":[{"code":"5601","type":"APR-DRG"}],"standard_charges":[{"minimum":8450,"maximum":8450,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":8450,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VAGINAL DELIVERY","code_information":[{"code":"5602","type":"APR-DRG"}],"standard_charges":[{"minimum":9431,"maximum":9431,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9431,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VAGINAL DELIVERY","code_information":[{"code":"5603","type":"APR-DRG"}],"standard_charges":[{"minimum":13274,"maximum":13274,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13274,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VAGINAL DELIVERY","code_information":[{"code":"5604","type":"APR-DRG"}],"standard_charges":[{"minimum":24955,"maximum":24955,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24955,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE","code_information":[{"code":"5611","type":"APR-DRG"}],"standard_charges":[{"minimum":6007,"maximum":6007,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":6007,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE","code_information":[{"code":"5612","type":"APR-DRG"}],"standard_charges":[{"minimum":10337,"maximum":10337,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10337,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE","code_information":[{"code":"5613","type":"APR-DRG"}],"standard_charges":[{"minimum":14374,"maximum":14374,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14374,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE","code_information":[{"code":"5614","type":"APR-DRG"}],"standard_charges":[{"minimum":31960,"maximum":31960,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31960,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABORTION WITHOUT D&C ASPIRATION CURETTAGE OR HYSTEROTOMY","code_information":[{"code":"5641","type":"APR-DRG"}],"standard_charges":[{"minimum":7285,"maximum":7285,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":7285,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABORTION WITHOUT D&C ASPIRATION CURETTAGE OR HYSTEROTOMY","code_information":[{"code":"5642","type":"APR-DRG"}],"standard_charges":[{"minimum":8439,"maximum":8439,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":8439,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABORTION WITHOUT D&C ASPIRATION CURETTAGE OR HYSTEROTOMY","code_information":[{"code":"5643","type":"APR-DRG"}],"standard_charges":[{"minimum":14631,"maximum":14631,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14631,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABORTION WITHOUT D&C ASPIRATION CURETTAGE OR HYSTEROTOMY","code_information":[{"code":"5644","type":"APR-DRG"}],"standard_charges":[{"minimum":38486,"maximum":38486,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38486,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANTEPARTUM WITHOUT O.R. PROCEDURE","code_information":[{"code":"5661","type":"APR-DRG"}],"standard_charges":[{"minimum":7974,"maximum":7974,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":7974,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANTEPARTUM WITHOUT O.R. PROCEDURE","code_information":[{"code":"5662","type":"APR-DRG"}],"standard_charges":[{"minimum":11937,"maximum":11937,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11937,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANTEPARTUM WITHOUT O.R. PROCEDURE","code_information":[{"code":"5663","type":"APR-DRG"}],"standard_charges":[{"minimum":17227,"maximum":17227,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17227,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANTEPARTUM WITHOUT O.R. PROCEDURE","code_information":[{"code":"5664","type":"APR-DRG"}],"standard_charges":[{"minimum":24464,"maximum":24464,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":24464,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PRB CENTURION VITRCT 25G","code_information":[{"code":"573641","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":328.5,"maximum":432,"gross_charge":450,"discounted_cash":261,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":427.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":432,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":328.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":373.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":328.5,"methodology":"fee schedule"}]}]},{"description":"PRB CENTURION VITRCT 25G","code_information":[{"code":"573641","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":144,"maximum":432,"gross_charge":450,"discounted_cash":261,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":427.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":432,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":328.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":373.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":328.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":216,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":156.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"}]}]},{"description":"NEONATE TRANSFERRED < 5 DAYS OLD NOT BORN HERE","code_information":[{"code":"5801","type":"APR-DRG"}],"standard_charges":[{"minimum":7061,"maximum":7061,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":7061,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE TRANSFERRED < 5 DAYS OLD NOT BORN HERE","code_information":[{"code":"5802","type":"APR-DRG"}],"standard_charges":[{"minimum":9926,"maximum":9926,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9926,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE TRANSFERRED < 5 DAYS OLD NOT BORN HERE","code_information":[{"code":"5803","type":"APR-DRG"}],"standard_charges":[{"minimum":16283,"maximum":16283,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16283,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE TRANSFERRED < 5 DAYS OLD NOT BORN HERE","code_information":[{"code":"5804","type":"APR-DRG"}],"standard_charges":[{"minimum":26699,"maximum":26699,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26699,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE TRANSFERRED < 5 DAYS OLD BORN HERE","code_information":[{"code":"5811","type":"APR-DRG"}],"standard_charges":[{"minimum":2470,"maximum":2470,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":2470,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ROOM-PRIVATE","code_information":[{"code":"5811000001","type":"CDM"},{"code":"0111","type":"RC"}],"standard_charges":[{"minimum":1038.06,"maximum":1365.12,"gross_charge":1422,"discounted_cash":824.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1350.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1365.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1038.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1180.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1038.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE TRANSFERRED < 5 DAYS OLD BORN HERE","code_information":[{"code":"5812","type":"APR-DRG"}],"standard_charges":[{"minimum":3683,"maximum":3683,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":3683,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ROOM -SEMI PRIVATE","code_information":[{"code":"5812000001","type":"CDM"},{"code":"0120","type":"RC"}],"standard_charges":[{"minimum":1004.48,"maximum":1320.96,"gross_charge":1376,"discounted_cash":798.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1307.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1320.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1004.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1142.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1004.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ROOM -SWING BED","code_information":[{"code":"5812000002","type":"CDM"},{"code":"0120","type":"RC"}],"standard_charges":[{"minimum":355.51,"maximum":467.52,"gross_charge":487,"discounted_cash":282.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":462.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":467.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":355.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":404.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":355.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE TRANSFERRED < 5 DAYS OLD BORN HERE","code_information":[{"code":"5813","type":"APR-DRG"}],"standard_charges":[{"minimum":8250,"maximum":8250,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":8250,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE TRANSFERRED < 5 DAYS OLD BORN HERE","code_information":[{"code":"5814","type":"APR-DRG"}],"standard_charges":[{"minimum":13020,"maximum":13020,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13020,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SEMI PRIVATE ROOM-NURSERY","code_information":[{"code":"5817000001","type":"CDM"},{"code":"0170","type":"RC"}],"standard_charges":[{"minimum":797.89,"maximum":1049.28,"gross_charge":1093,"discounted_cash":633.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1038.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1049.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":797.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":907.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":797.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE WITH ECMO","code_information":[{"code":"5831","type":"APR-DRG"}],"standard_charges":[{"minimum":397499,"maximum":397499,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":397499,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE WITH ECMO","code_information":[{"code":"5832","type":"APR-DRG"}],"standard_charges":[{"minimum":459973,"maximum":459973,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":459973,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE WITH ECMO","code_information":[{"code":"5833","type":"APR-DRG"}],"standard_charges":[{"minimum":623773,"maximum":623773,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":623773,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE WITH ECMO","code_information":[{"code":"5834","type":"APR-DRG"}],"standard_charges":[{"minimum":787573,"maximum":787573,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":787573,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SIGMOIDOSCOPY W HEMORRHOID BAN","code_information":[{"code":"5836000061","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":825.63,"maximum":1085.76,"gross_charge":1131,"discounted_cash":655.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1074.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1085.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":825.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":938.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":825.63,"methodology":"fee schedule"}]}]},{"description":"SIGMOIDOSCOPY W HEMORRHOID BAN","code_information":[{"code":"5836000061","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":361.92,"maximum":1085.76,"gross_charge":1131,"discounted_cash":655.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1074.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1085.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":825.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":938.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":825.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":542.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":392.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":361.92,"methodology":"fee schedule"}]}]},{"description":"SIGMOIDOSCOPY W HEMORRHOID BAN","code_information":[{"code":"583600061","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":845.34,"maximum":1111.68,"gross_charge":1158,"discounted_cash":671.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1100.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1111.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":845.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":961.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":845.34,"methodology":"fee schedule"}]}]},{"description":"SIGMOIDOSCOPY W HEMORRHOID BAN","code_information":[{"code":"583600061","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":370.56,"maximum":1111.68,"gross_charge":1158,"discounted_cash":671.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1100.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1111.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":845.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":961.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":845.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":555.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":401.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":370.56,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 FIRST 30 MINS","code_information":[{"code":"5836010130","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2539.67,"maximum":3339.84,"gross_charge":3479,"discounted_cash":2017.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3305.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3339.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2539.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2887.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2539.67,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 FIRST 30 MINS","code_information":[{"code":"5836010130","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1113.28,"maximum":3339.84,"gross_charge":3479,"discounted_cash":2017.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3305.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3339.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2539.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2887.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2539.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1669.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1206.52,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1113.28,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 ADDL 15 MINS","code_information":[{"code":"5836010135","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":508.08,"maximum":668.16,"gross_charge":696,"discounted_cash":403.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":661.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":668.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":508.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":577.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":508.08,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 2 ADDL 15 MINS","code_information":[{"code":"5836010135","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":222.72,"maximum":668.16,"gross_charge":696,"discounted_cash":403.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":661.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":668.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":508.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":577.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":508.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":334.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":241.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":222.72,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 FIRST 30 MINS","code_information":[{"code":"5836010140","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":3864.62,"maximum":5082.24,"gross_charge":5294,"discounted_cash":3070.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5029.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5082.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3864.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4394.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3864.62,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 FIRST 30 MINS","code_information":[{"code":"5836010140","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1694.08,"maximum":5082.24,"gross_charge":5294,"discounted_cash":3070.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":5029.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":5082.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3864.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4394.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3864.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2541.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1835.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1694.08,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 ADDL 15 MINS","code_information":[{"code":"5836010145","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":773.07,"maximum":1016.64,"gross_charge":1059,"discounted_cash":614.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1006.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1016.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":773.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":878.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":773.07,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 3 ADDL 15 MINS","code_information":[{"code":"5836010145","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":338.88,"maximum":1016.64,"gross_charge":1059,"discounted_cash":614.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1006.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1016.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":773.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":878.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":773.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":508.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":367.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":338.88,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 FIRST 30 MINS","code_information":[{"code":"5836010150","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":5603.48,"maximum":7368.96,"gross_charge":7676,"discounted_cash":4452.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7292.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7368.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5603.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6371.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5603.48,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 FIRST 30 MINS","code_information":[{"code":"5836010150","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":2456.32,"maximum":7368.96,"gross_charge":7676,"discounted_cash":4452.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7292.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7368.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5603.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6371.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5603.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3684.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2662.04,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2456.32,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 ADDL 15 MINS","code_information":[{"code":"5836010155","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1121.28,"maximum":1474.56,"gross_charge":1536,"discounted_cash":890.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1459.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1474.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1121.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1274.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1121.28,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 4 ADDL 15 MINS","code_information":[{"code":"5836010155","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":491.52,"maximum":1474.56,"gross_charge":1536,"discounted_cash":890.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1459.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1474.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1121.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1274.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1121.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":737.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":532.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":491.52,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 FIRST 30 MINS","code_information":[{"code":"5836010160","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":8124.9,"maximum":10684.8,"gross_charge":11130,"discounted_cash":6455.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":10573.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":10684.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8124.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9237.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8124.9,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 FIRST 30 MINS","code_information":[{"code":"5836010160","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":3561.6,"maximum":10684.8,"gross_charge":11130,"discounted_cash":6455.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":10573.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":10684.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8124.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9237.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8124.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5342.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":3859.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3561.6,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 ADDL 15 MINS","code_information":[{"code":"5836010165","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":1625.71,"maximum":2137.92,"gross_charge":2227,"discounted_cash":1291.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2115.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2137.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1625.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1848.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1625.71,"methodology":"fee schedule"}]}]},{"description":"OR LEVEL 5 ADDL 15 MINS","code_information":[{"code":"5836010165","type":"CDM"},{"code":"0360","type":"RC"}],"standard_charges":[{"minimum":712.64,"maximum":2137.92,"gross_charge":2227,"discounted_cash":1291.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2115.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2137.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1625.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1848.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1625.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1068.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":772.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":712.64,"methodology":"fee schedule"}]}]},{"description":"SEALR LAP BLNT TP DIV","code_information":[{"code":"585495","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":951.19,"maximum":1250.88,"gross_charge":1303,"discounted_cash":755.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1237.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1250.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":951.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1081.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":951.19,"methodology":"fee schedule"}]}]},{"description":"SEALR LAP BLNT TP DIV","code_information":[{"code":"585495","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":416.96,"maximum":1250.88,"gross_charge":1303,"discounted_cash":755.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1237.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1250.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":951.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1081.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":951.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":625.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":451.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":416.96,"methodology":"fee schedule"}]}]},{"description":"NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE","code_information":[{"code":"5881","type":"APR-DRG"}],"standard_charges":[{"minimum":268254,"maximum":268254,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":268254,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE","code_information":[{"code":"5882","type":"APR-DRG"}],"standard_charges":[{"minimum":407532,"maximum":407532,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":407532,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE","code_information":[{"code":"5883","type":"APR-DRG"}],"standard_charges":[{"minimum":422263,"maximum":422263,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":422263,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE","code_information":[{"code":"5884","type":"APR-DRG"}],"standard_charges":[{"minimum":589506,"maximum":589506,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":589506,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT < 500 GRAMS OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION","code_information":[{"code":"5891","type":"APR-DRG"}],"standard_charges":[{"minimum":126218,"maximum":126218,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":126218,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT < 500 GRAMS OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION","code_information":[{"code":"5892","type":"APR-DRG"}],"standard_charges":[{"minimum":104780,"maximum":104780,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":104780,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT < 500 GRAMS OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION","code_information":[{"code":"5893","type":"APR-DRG"}],"standard_charges":[{"minimum":70679,"maximum":70679,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":70679,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT < 500 GRAMS OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION","code_information":[{"code":"5894","type":"APR-DRG"}],"standard_charges":[{"minimum":1500,"maximum":1500,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":1500,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE","code_information":[{"code":"5911","type":"APR-DRG"}],"standard_charges":[{"minimum":3446,"maximum":3446,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":3446,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE","code_information":[{"code":"5912","type":"APR-DRG"}],"standard_charges":[{"minimum":126836,"maximum":126836,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":126836,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE","code_information":[{"code":"5913","type":"APR-DRG"}],"standard_charges":[{"minimum":224981,"maximum":224981,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":224981,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE","code_information":[{"code":"5914","type":"APR-DRG"}],"standard_charges":[{"minimum":462838,"maximum":462838,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":462838,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE","code_information":[{"code":"5931","type":"APR-DRG"}],"standard_charges":[{"minimum":199910,"maximum":199910,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":199910,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE","code_information":[{"code":"5932","type":"APR-DRG"}],"standard_charges":[{"minimum":222122,"maximum":222122,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":222122,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE","code_information":[{"code":"5933","type":"APR-DRG"}],"standard_charges":[{"minimum":352451,"maximum":352451,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":352451,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE","code_information":[{"code":"5934","type":"APR-DRG"}],"standard_charges":[{"minimum":460047,"maximum":460047,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":460047,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MARKER XR LD ENDOSCP 5ML","code_information":[{"code":"595362","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":100.74,"maximum":132.48,"gross_charge":138,"discounted_cash":80.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":131.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":132.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":100.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":114.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":100.74,"methodology":"fee schedule"}]}]},{"description":"MARKER XR LD ENDOSCP 5ML","code_information":[{"code":"595362","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":44.16,"maximum":132.48,"gross_charge":138,"discounted_cash":80.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":131.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":132.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":100.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":114.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":100.74,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":66.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":47.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":44.16,"methodology":"fee schedule"}]}]},{"description":"BLDE SPECTRUM MAC S3","code_information":[{"code":"599405","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":107.46,"maximum":141.32,"gross_charge":147.2,"discounted_cash":85.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":139.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":141.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":107.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":107.46,"methodology":"fee schedule"}]}]},{"description":"BLDE SPECTRUM MAC S3","code_information":[{"code":"599405","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":47.11,"maximum":141.32,"gross_charge":147.2,"discounted_cash":85.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":139.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":141.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":107.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":107.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":70.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":51.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.11,"methodology":"fee schedule"}]}]},{"description":"DRSNG ALLEVYN SHR PRF 4X4IN","code_information":[{"code":"600513","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":9.19,"maximum":12.08,"gross_charge":12.58,"discounted_cash":7.3,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":12.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":9.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":9.19,"methodology":"fee schedule"}]}]},{"description":"DRSNG ALLEVYN SHR PRF 4X4IN","code_information":[{"code":"600513","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":4.03,"maximum":12.08,"gross_charge":12.58,"discounted_cash":7.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":12.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":9.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":10.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":9.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":6.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":4.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":4.03,"methodology":"fee schedule"}]}]},{"description":"NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY","code_information":[{"code":"6021","type":"APR-DRG"}],"standard_charges":[{"minimum":191460,"maximum":191460,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":191460,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY","code_information":[{"code":"6022","type":"APR-DRG"}],"standard_charges":[{"minimum":212732,"maximum":212732,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":212732,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY","code_information":[{"code":"6023","type":"APR-DRG"}],"standard_charges":[{"minimum":336142,"maximum":336142,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":336142,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY","code_information":[{"code":"6024","type":"APR-DRG"}],"standard_charges":[{"minimum":382207,"maximum":382207,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":382207,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SODIUM CHLORIDE 0.45% 500 ML BAG","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603000005","type":"CDM"},{"code":"0636","type":"RC"},{"code":"00264-7802-10","type":"NDC"}],"standard_charges":[{"minimum":9.77,"maximum":12.84,"gross_charge":13.37,"discounted_cash":7.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":12.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":9.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":9.77,"methodology":"fee schedule"}]}]},{"description":"SODIUM CHLORIDE 0.45% 500 ML BAG","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603000005","type":"CDM"},{"code":"0636","type":"RC"},{"code":"00264-7802-10","type":"NDC"}],"standard_charges":[{"minimum":4.28,"maximum":12.84,"gross_charge":13.37,"discounted_cash":7.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":12.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":9.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":11.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":9.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":6.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":4.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":4.28,"methodology":"fee schedule"}]}]},{"description":"AMOX/CLAV 600-42.9MG/5 ML 75ML","code_information":[{"code":"603000232","type":"CDM"},{"code":"0250","type":"RC"}],"standard_charges":[{"minimum":0.01,"maximum":0.01,"gross_charge":0.01,"discounted_cash":0.01,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.01,"methodology":"fee schedule"}]}]},{"description":"AMOX/CLAV 600-42.9MG/5 ML 75ML","code_information":[{"code":"603000232","type":"CDM"},{"code":"0250","type":"RC"}],"standard_charges":[{"minimum":0.01,"maximum":0.01,"gross_charge":0.01,"discounted_cash":0.01,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"}]}]},{"description":"DILTIAZEM 90 MG TAB","drug_information": {"unit": 1,"type": "ME"},"code_information":[{"code":"603001242","type":"CDM"},{"code":"0636","type":"RC"},{"code":"51079-0747-20","type":"NDC"}],"standard_charges":[{"minimum":2.2,"maximum":2.89,"gross_charge":3.01,"discounted_cash":1.75,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2.89,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.2,"methodology":"fee schedule"}]}]},{"description":"DILTIAZEM 90 MG TAB","drug_information": {"unit": 1,"type": "ME"},"code_information":[{"code":"603001242","type":"CDM"},{"code":"0636","type":"RC"},{"code":"51079-0747-20","type":"NDC"}],"standard_charges":[{"minimum":0.97,"maximum":2.89,"gross_charge":3.01,"discounted_cash":1.75,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2.89,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.97,"methodology":"fee schedule"}]}]},{"description":"FLUTICASONE/SALMETEROL HFA 115-21 MCG 12 GM INHALER","code_information":[{"code":"603001724","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":67.92,"maximum":89.31,"gross_charge":93.03,"discounted_cash":53.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":88.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":89.31,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":67.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":67.92,"methodology":"fee schedule"}]}]},{"description":"FLUTICASONE/SALMETEROL HFA 115-21 MCG 12 GM INHALER","code_information":[{"code":"603001724","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":29.77,"maximum":89.31,"gross_charge":93.03,"discounted_cash":53.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":88.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":89.31,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":67.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":67.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":44.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":29.77,"methodology":"fee schedule"}]}]},{"description":"HYDROCORTISONE POWDER 10 GM JAR","code_information":[{"code":"603001978","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":94.54,"maximum":124.32,"gross_charge":129.5,"discounted_cash":75.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":123.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":124.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":94.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":107.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":94.54,"methodology":"fee schedule"}]}]},{"description":"HYDROCORTISONE POWDER 10 GM JAR","code_information":[{"code":"603001978","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":41.44,"maximum":124.32,"gross_charge":129.5,"discounted_cash":75.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":123.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":124.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":94.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":107.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":94.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":62.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":44.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":41.44,"methodology":"fee schedule"}]}]},{"description":"NEO-SYNEPHRINE 2.5% OPHTH SOLN","drug_information": {"unit": 1,"type": "UN"},"code_information":[{"code":"603003434","type":"CDM"},{"code":"0636","type":"RC"},{"code":"17478-0201-02","type":"NDC"}],"standard_charges":[{"minimum":103.82,"maximum":136.53,"gross_charge":142.21,"discounted_cash":82.49,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":135.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":136.53,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":103.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":118.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":103.82,"methodology":"fee schedule"}]}]},{"description":"NEO-SYNEPHRINE 2.5% OPHTH SOLN","drug_information": {"unit": 1,"type": "UN"},"code_information":[{"code":"603003434","type":"CDM"},{"code":"0636","type":"RC"},{"code":"17478-0201-02","type":"NDC"}],"standard_charges":[{"minimum":45.51,"maximum":136.53,"gross_charge":142.21,"discounted_cash":82.49,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":135.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":136.53,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":103.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":118.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":103.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":49.32,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":45.51,"methodology":"fee schedule"}]}]},{"description":"ROTAVIRUS VACCINE LIVE PENTAVALENT 2 ML ORAL SYRINGE","code_information":[{"code":"603003839","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":293.83,"maximum":386.4,"gross_charge":402.5,"discounted_cash":233.45,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":382.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":386.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":293.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":334.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":293.83,"methodology":"fee schedule"}]}]},{"description":"ROTAVIRUS VACCINE LIVE PENTAVALENT 2 ML ORAL SYRINGE","code_information":[{"code":"603003839","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":128.8,"maximum":386.4,"gross_charge":402.5,"discounted_cash":233.45,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":382.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":386.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":293.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":334.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":293.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":193.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":139.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":128.8,"methodology":"fee schedule"}]}]},{"description":"SELENIUM SULFIDE 1% SHAMPOO 240 ML BOTTLE","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603003868","type":"CDM"},{"code":"0636","type":"RC"},{"code":"00536-1995-53","type":"NDC"}],"standard_charges":[{"minimum":8.57,"maximum":11.27,"gross_charge":11.73,"discounted_cash":6.81,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11.27,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8.57,"methodology":"fee schedule"}]}]},{"description":"SELENIUM SULFIDE 1% SHAMPOO 240 ML BOTTLE","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603003868","type":"CDM"},{"code":"0636","type":"RC"},{"code":"00536-1995-53","type":"NDC"}],"standard_charges":[{"minimum":3.76,"maximum":11.27,"gross_charge":11.73,"discounted_cash":6.81,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":11.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":11.27,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":8.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":9.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":8.57,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":5.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":4.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":3.76,"methodology":"fee schedule"}]}]},{"description":"SOD CHLOR.9% IRR 1000ML CONT","code_information":[{"code":"603003929","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":0.01,"maximum":0.01,"gross_charge":0.01,"discounted_cash":0.01,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.01,"methodology":"fee schedule"}]}]},{"description":"SOD CHLOR.9% IRR 1000ML CONT","code_information":[{"code":"603003929","type":"CDM"},{"code":"0258","type":"RC"}],"standard_charges":[{"minimum":0.01,"maximum":0.01,"gross_charge":0.01,"discounted_cash":0.01,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"}]}]},{"description":"DIPHTHERIA/TETANUS TOXOIDSPEDIATRIC (DT) 0.5 ML SDV","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603004111","type":"CDM"},{"code":"0636","type":"RC"},{"code":"49281-0225-10","type":"NDC"}],"standard_charges":[{"minimum":165.04,"maximum":217.03,"gross_charge":226.07,"discounted_cash":131.13,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":214.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.03,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":187.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.04,"methodology":"fee schedule"}]}]},{"description":"DIPHTHERIA/TETANUS TOXOIDSPEDIATRIC (DT) 0.5 ML SDV","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603004111","type":"CDM"},{"code":"0636","type":"RC"},{"code":"49281-0225-10","type":"NDC"}],"standard_charges":[{"minimum":72.35,"maximum":217.03,"gross_charge":226.07,"discounted_cash":131.13,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":214.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.03,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":187.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.35,"methodology":"fee schedule"}]}]},{"description":"MYDRIACYL 1% OPHTH SOLN","drug_information": {"unit": 1,"type": "UN"},"code_information":[{"code":"603004311","type":"CDM"},{"code":"0636","type":"RC"},{"code":"61314-0355-01","type":"NDC"}],"standard_charges":[{"minimum":35.77,"maximum":47.04,"gross_charge":49,"discounted_cash":28.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":46.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.77,"methodology":"fee schedule"}]}]},{"description":"MYDRIACYL 1% OPHTH SOLN","drug_information": {"unit": 1,"type": "UN"},"code_information":[{"code":"603004311","type":"CDM"},{"code":"0636","type":"RC"},{"code":"61314-0355-01","type":"NDC"}],"standard_charges":[{"minimum":15.68,"maximum":47.04,"gross_charge":49,"discounted_cash":28.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":46.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":15.68,"methodology":"fee schedule"}]}]},{"description":"CENTRAL TOTAL PARENTERAL NUTRI","code_information":[{"code":"603004519","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":130.8,"maximum":172.01,"gross_charge":179.17,"discounted_cash":103.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":170.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":172.01,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":130.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":148.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":130.8,"methodology":"fee schedule"}]}]},{"description":"CENTRAL TOTAL PARENTERAL NUTRI","code_information":[{"code":"603004519","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":57.34,"maximum":172.01,"gross_charge":179.17,"discounted_cash":103.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":170.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":172.01,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":130.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":148.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":130.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":62.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":57.34,"methodology":"fee schedule"}]}]},{"description":"COAL TAR SHAMPOO 251 ML BOTTLE","code_information":[{"code":"603004905","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":5.91,"maximum":7.77,"gross_charge":8.09,"discounted_cash":4.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7.77,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.91,"methodology":"fee schedule"}]}]},{"description":"COAL TAR SHAMPOO 251 ML BOTTLE","code_information":[{"code":"603004905","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":2.59,"maximum":7.77,"gross_charge":8.09,"discounted_cash":4.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7.77,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2.81,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2.59,"methodology":"fee schedule"}]}]},{"description":"IMMUNE GLOBULINGAMMA (IGG) 5 GM/50 ML SDV","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603005271","type":"CDM"},{"code":"0636","type":"RC"},{"code":"59730-6502-01","type":"NDC"}],"standard_charges":[{"minimum":2039.66,"maximum":2682.29,"gross_charge":2794.05,"discounted_cash":1620.55,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2654.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2682.29,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2039.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2319.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2039.66,"methodology":"fee schedule"}]}]},{"description":"IMMUNE GLOBULINGAMMA (IGG) 5 GM/50 ML SDV","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603005271","type":"CDM"},{"code":"0636","type":"RC"},{"code":"59730-6502-01","type":"NDC"}],"standard_charges":[{"minimum":894.1,"maximum":2682.29,"gross_charge":2794.05,"discounted_cash":1620.55,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2654.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2682.29,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2039.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2319.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2039.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1341.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":968.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":894.1,"methodology":"fee schedule"}]}]},{"description":"HEP B VACCINE/DP(A)T-POLIO/PF 0.5 ML SYRINGE","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603005279","type":"CDM"},{"code":"0636","type":"RC"},{"code":"58160-0811-52","type":"NDC"}],"standard_charges":[{"minimum":255.18,"maximum":335.57,"gross_charge":349.55,"discounted_cash":202.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":332.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":335.57,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":255.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":290.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":255.18,"methodology":"fee schedule"}]}]},{"description":"HEP B VACCINE/DP(A)T-POLIO/PF 0.5 ML SYRINGE","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603005279","type":"CDM"},{"code":"0636","type":"RC"},{"code":"58160-0811-52","type":"NDC"}],"standard_charges":[{"minimum":111.86,"maximum":335.57,"gross_charge":349.55,"discounted_cash":202.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":332.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":335.57,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":255.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":290.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":255.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":167.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":121.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":111.86,"methodology":"fee schedule"}]}]},{"description":"OXYTOCIN/LACTATED RINGERS 30 UNITS/500 ML BAG","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603005452","type":"CDM"},{"code":"0636","type":"RC"},{"code":"70092-1071-24","type":"NDC"}],"standard_charges":[{"minimum":69.68,"maximum":91.64,"gross_charge":95.45,"discounted_cash":55.37,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":90.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":91.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":69.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":79.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":69.68,"methodology":"fee schedule"}]}]},{"description":"OXYTOCIN/LACTATED RINGERS 30 UNITS/500 ML BAG","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603005452","type":"CDM"},{"code":"0636","type":"RC"},{"code":"70092-1071-24","type":"NDC"}],"standard_charges":[{"minimum":30.55,"maximum":91.64,"gross_charge":95.45,"discounted_cash":55.37,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":90.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":91.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":69.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":79.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":69.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":45.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":33.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":30.55,"methodology":"fee schedule"}]}]},{"description":"FOL ACID/VIT B CMPLX W/C 0.8MG","drug_information": {"unit": 1,"type": "ME"},"code_information":[{"code":"603005549","type":"CDM"},{"code":"0636","type":"RC"},{"code":"60258-0160-01","type":"NDC"}],"standard_charges":[{"minimum":0.81,"maximum":1.06,"gross_charge":1.1,"discounted_cash":0.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1.06,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.81,"methodology":"fee schedule"}]}]},{"description":"FOL ACID/VIT B CMPLX W/C 0.8MG","drug_information": {"unit": 1,"type": "ME"},"code_information":[{"code":"603005549","type":"CDM"},{"code":"0636","type":"RC"},{"code":"60258-0160-01","type":"NDC"}],"standard_charges":[{"minimum":0.36,"maximum":1.06,"gross_charge":1.1,"discounted_cash":0.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1.06,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":0.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":0.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.36,"methodology":"fee schedule"}]}]},{"description":"BUPRENORPHINE HCL 2 MG TAB SUBLINGUAL","code_information":[{"code":"603005554","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":11.5,"maximum":15.12,"gross_charge":15.75,"discounted_cash":9.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":14.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":15.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":11.5,"methodology":"fee schedule"}]}]},{"description":"BUPRENORPHINE HCL 2 MG TAB SUBLINGUAL","code_information":[{"code":"603005554","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":5.04,"maximum":15.12,"gross_charge":15.75,"discounted_cash":9.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":14.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":15.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":11.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":7.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":5.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.04,"methodology":"fee schedule"}]}]},{"description":"TRULICITY","code_information":[{"code":"603006023","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":630.58,"maximum":829.25,"gross_charge":863.8,"discounted_cash":501.01,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":820.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":829.25,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":630.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":716.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":630.58,"methodology":"fee schedule"}]}]},{"description":"TRULICITY","code_information":[{"code":"603006023","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":276.42,"maximum":829.25,"gross_charge":863.8,"discounted_cash":501.01,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":820.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":829.25,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":630.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":716.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":630.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":414.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":299.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":276.42,"methodology":"fee schedule"}]}]},{"description":"ARIPIPRAZOLE 300 MG SUSER.SYR","drug_information": {"unit": 1,"type": "ME"},"code_information":[{"code":"603006197","type":"CDM"},{"code":"0636","type":"RC"},{"code":"59148-0045-80","type":"NDC"}],"standard_charges":[{"minimum":5565.64,"maximum":7319.2,"gross_charge":7624.16,"discounted_cash":4422.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7242.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7319.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5565.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6328.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5565.64,"methodology":"fee schedule"}]}]},{"description":"ARIPIPRAZOLE 300 MG SUSER.SYR","drug_information": {"unit": 1,"type": "ME"},"code_information":[{"code":"603006197","type":"CDM"},{"code":"0636","type":"RC"},{"code":"59148-0045-80","type":"NDC"}],"standard_charges":[{"minimum":2439.74,"maximum":7319.2,"gross_charge":7624.16,"discounted_cash":4422.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":7242.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":7319.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":5565.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":6328.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":5565.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3659.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2644.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2439.74,"methodology":"fee schedule"}]}]},{"description":"CYCL1%-TROP1%-PE 2.5% SDV DROP","drug_information": {"unit": 1,"type": "ME"},"code_information":[{"code":"603006290","type":"CDM"},{"code":"0636","type":"RC"},{"code":"71449-0092-45","type":"NDC"}],"standard_charges":[{"minimum":120.73,"maximum":158.77,"gross_charge":165.38,"discounted_cash":95.93,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":157.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":158.77,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":120.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":120.73,"methodology":"fee schedule"}]}]},{"description":"CYCL1%-TROP1%-PE 2.5% SDV DROP","drug_information": {"unit": 1,"type": "ME"},"code_information":[{"code":"603006290","type":"CDM"},{"code":"0636","type":"RC"},{"code":"71449-0092-45","type":"NDC"}],"standard_charges":[{"minimum":52.93,"maximum":158.77,"gross_charge":165.38,"discounted_cash":95.93,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":157.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":158.77,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":120.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":137.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":120.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":57.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":52.93,"methodology":"fee schedule"}]}]},{"description":"KETAMINE 20 MG/2 ML-0.9% NACL","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603006311","type":"CDM"},{"code":"0636","type":"RC"},{"code":"70092-1563-43","type":"NDC"}],"standard_charges":[{"minimum":21.14,"maximum":27.8,"gross_charge":28.95,"discounted_cash":16.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":27.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.14,"methodology":"fee schedule"}]}]},{"description":"KETAMINE 20 MG/2 ML-0.9% NACL","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603006311","type":"CDM"},{"code":"0636","type":"RC"},{"code":"70092-1563-43","type":"NDC"}],"standard_charges":[{"minimum":9.27,"maximum":27.8,"gross_charge":28.95,"discounted_cash":16.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":27.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":13.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.04,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.27,"methodology":"fee schedule"}]}]},{"description":"DEXMEDETO/0.9% NACL 200 MCG/50","code_information":[{"code":"603006317","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":1257.09,"maximum":1653.16,"gross_charge":1722.04,"discounted_cash":998.79,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1635.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1653.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1257.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1429.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1257.09,"methodology":"fee schedule"}]}]},{"description":"DEXMEDETO/0.9% NACL 200 MCG/50","code_information":[{"code":"603006317","type":"CDM"},{"code":"0636","type":"RC"}],"standard_charges":[{"minimum":551.06,"maximum":1653.16,"gross_charge":1722.04,"discounted_cash":998.79,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1635.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1653.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1257.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1429.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1257.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":826.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":597.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":551.06,"methodology":"fee schedule"}]}]},{"description":"SODIUMBICARB 4.2% 5MEQ/10ML","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603006407","type":"CDM"},{"code":"0636","type":"RC"},{"code":"51754-5012-01","type":"NDC"}],"standard_charges":[{"minimum":60.13,"maximum":79.07,"gross_charge":82.36,"discounted_cash":47.77,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":78.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":79.07,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":60.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":60.13,"methodology":"fee schedule"}]}]},{"description":"SODIUMBICARB 4.2% 5MEQ/10ML","drug_information": {"unit": 1,"type": "ML"},"code_information":[{"code":"603006407","type":"CDM"},{"code":"0636","type":"RC"},{"code":"51754-5012-01","type":"NDC"}],"standard_charges":[{"minimum":26.36,"maximum":79.07,"gross_charge":82.36,"discounted_cash":47.77,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":78.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":79.07,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":60.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":68.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":60.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":28.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":26.36,"methodology":"fee schedule"}]}]},{"description":"VANCOMYCIN 2 GM SDV","drug_information": {"unit": 1,"type": "GR"},"code_information":[{"code":"603006408","type":"CDM"},{"code":"0636","type":"RC"},{"code":"72078-0066-99","type":"NDC"}],"standard_charges":[{"minimum":109.36,"maximum":143.81,"gross_charge":149.8,"discounted_cash":86.89,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":142.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":143.81,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":109.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":109.36,"methodology":"fee schedule"}]}]},{"description":"VANCOMYCIN 2 GM SDV","drug_information": {"unit": 1,"type": "GR"},"code_information":[{"code":"603006408","type":"CDM"},{"code":"0636","type":"RC"},{"code":"72078-0066-99","type":"NDC"}],"standard_charges":[{"minimum":47.94,"maximum":143.81,"gross_charge":149.8,"discounted_cash":86.89,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":142.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":143.81,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":109.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":109.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":51.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.94,"methodology":"fee schedule"}]}]},{"description":"BARIUM SULFATE 40% W/V P...","code_information":[{"code":"603006409","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":0.01,"maximum":0.01,"gross_charge":0.01,"discounted_cash":0.01,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.01,"methodology":"fee schedule"}]}]},{"description":"BARIUM SULFATE 40% W/V P...","code_information":[{"code":"603006409","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":0.01,"maximum":0.01,"gross_charge":0.01,"discounted_cash":0.01,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":0.01,"methodology":"fee schedule"}]}]},{"description":"NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION","code_information":[{"code":"6031","type":"APR-DRG"}],"standard_charges":[{"minimum":73183,"maximum":73183,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":73183,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION","code_information":[{"code":"6032","type":"APR-DRG"}],"standard_charges":[{"minimum":81316,"maximum":81316,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":81316,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION","code_information":[{"code":"6033","type":"APR-DRG"}],"standard_charges":[{"minimum":164811,"maximum":164811,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":164811,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION","code_information":[{"code":"6034","type":"APR-DRG"}],"standard_charges":[{"minimum":338679,"maximum":338679,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":338679,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY","code_information":[{"code":"6071","type":"APR-DRG"}],"standard_charges":[{"minimum":62159,"maximum":62159,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":62159,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY","code_information":[{"code":"6072","type":"APR-DRG"}],"standard_charges":[{"minimum":133384,"maximum":133384,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":133384,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY","code_information":[{"code":"6073","type":"APR-DRG"}],"standard_charges":[{"minimum":242686,"maximum":242686,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":242686,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY","code_information":[{"code":"6074","type":"APR-DRG"}],"standard_charges":[{"minimum":311954,"maximum":311954,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":311954,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION","code_information":[{"code":"6081","type":"APR-DRG"}],"standard_charges":[{"minimum":13990,"maximum":13990,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13990,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION","code_information":[{"code":"6082","type":"APR-DRG"}],"standard_charges":[{"minimum":109022,"maximum":109022,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":109022,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION","code_information":[{"code":"6083","type":"APR-DRG"}],"standard_charges":[{"minimum":139880,"maximum":139880,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":139880,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION","code_information":[{"code":"6084","type":"APR-DRG"}],"standard_charges":[{"minimum":146875,"maximum":146875,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":146875,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE","code_information":[{"code":"6091","type":"APR-DRG"}],"standard_charges":[{"minimum":90884,"maximum":90884,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":90884,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE","code_information":[{"code":"6092","type":"APR-DRG"}],"standard_charges":[{"minimum":95667,"maximum":95667,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":95667,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE","code_information":[{"code":"6093","type":"APR-DRG"}],"standard_charges":[{"minimum":201408,"maximum":201408,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":201408,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE","code_information":[{"code":"6094","type":"APR-DRG"}],"standard_charges":[{"minimum":404268,"maximum":404268,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":404268,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DRSNG PICO 7 SNGL 10X20CM","code_information":[{"code":"610445","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":455.52,"maximum":599.04,"gross_charge":624,"discounted_cash":361.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":592.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":599.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":455.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":517.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":455.52,"methodology":"fee schedule"}]}]},{"description":"DRSNG PICO 7 SNGL 10X20CM","code_information":[{"code":"610445","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":199.68,"maximum":599.04,"gross_charge":624,"discounted_cash":361.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":592.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":599.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":455.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":517.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":455.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":299.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":216.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":199.68,"methodology":"fee schedule"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6111","type":"APR-DRG"}],"standard_charges":[{"minimum":28708,"maximum":28708,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28708,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6112","type":"APR-DRG"}],"standard_charges":[{"minimum":76023,"maximum":76023,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":76023,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6113","type":"APR-DRG"}],"standard_charges":[{"minimum":141064,"maximum":141064,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":141064,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6114","type":"APR-DRG"}],"standard_charges":[{"minimum":178233,"maximum":178233,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":178233,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6121","type":"APR-DRG"}],"standard_charges":[{"minimum":77827,"maximum":77827,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":77827,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6122","type":"APR-DRG"}],"standard_charges":[{"minimum":138995,"maximum":138995,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":138995,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6123","type":"APR-DRG"}],"standard_charges":[{"minimum":160350,"maximum":160350,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":160350,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6124","type":"APR-DRG"}],"standard_charges":[{"minimum":228007,"maximum":228007,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":228007,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6131","type":"APR-DRG"}],"standard_charges":[{"minimum":36919,"maximum":36919,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36919,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6132","type":"APR-DRG"}],"standard_charges":[{"minimum":67003,"maximum":67003,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":67003,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6133","type":"APR-DRG"}],"standard_charges":[{"minimum":107846,"maximum":107846,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":107846,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6134","type":"APR-DRG"}],"standard_charges":[{"minimum":165385,"maximum":165385,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":165385,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6141","type":"APR-DRG"}],"standard_charges":[{"minimum":33019,"maximum":33019,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33019,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6142","type":"APR-DRG"}],"standard_charges":[{"minimum":71051,"maximum":71051,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":71051,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6143","type":"APR-DRG"}],"standard_charges":[{"minimum":104193,"maximum":104193,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":104193,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6144","type":"APR-DRG"}],"standard_charges":[{"minimum":132905,"maximum":132905,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":132905,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STYLET GLIDERITE LG","code_information":[{"code":"619400","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":25.77,"maximum":33.88,"gross_charge":35.29,"discounted_cash":20.47,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":33.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":33.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":25.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":25.77,"methodology":"fee schedule"}]}]},{"description":"STYLET GLIDERITE LG","code_information":[{"code":"619400","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":11.3,"maximum":33.88,"gross_charge":35.29,"discounted_cash":20.47,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":33.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":33.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":25.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":25.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":16.94,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":12.24,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":11.3,"methodology":"fee schedule"}]}]},{"description":"SYS BLLN DISSECT CTR23 KII RND","code_information":[{"code":"620762","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":620.5,"maximum":816,"gross_charge":850,"discounted_cash":493,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":807.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":816,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":620.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":705.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":620.5,"methodology":"fee schedule"}]}]},{"description":"SYS BLLN DISSECT CTR23 KII RND","code_information":[{"code":"620762","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":272,"maximum":816,"gross_charge":850,"discounted_cash":493,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":807.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":816,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":620.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":705.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":620.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":408,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":294.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":272,"methodology":"fee schedule"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6211","type":"APR-DRG"}],"standard_charges":[{"minimum":19425,"maximum":19425,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19425,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6212","type":"APR-DRG"}],"standard_charges":[{"minimum":66716,"maximum":66716,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":66716,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6213","type":"APR-DRG"}],"standard_charges":[{"minimum":97326,"maximum":97326,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":97326,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6214","type":"APR-DRG"}],"standard_charges":[{"minimum":153952,"maximum":153952,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":153952,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6221","type":"APR-DRG"}],"standard_charges":[{"minimum":65766,"maximum":65766,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":65766,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6222","type":"APR-DRG"}],"standard_charges":[{"minimum":87608,"maximum":87608,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":87608,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6223","type":"APR-DRG"}],"standard_charges":[{"minimum":91838,"maximum":91838,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":91838,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6224","type":"APR-DRG"}],"standard_charges":[{"minimum":99365,"maximum":99365,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":99365,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6231","type":"APR-DRG"}],"standard_charges":[{"minimum":25418,"maximum":25418,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25418,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6232","type":"APR-DRG"}],"standard_charges":[{"minimum":41204,"maximum":41204,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41204,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"THORACIC EPIDURAL INJ WO GUID","code_information":[{"code":"62320","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1443.21,"maximum":1897.92,"gross_charge":1977,"discounted_cash":1146.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1878.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1897.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1640.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1443.21,"methodology":"fee schedule"}]}]},{"description":"THORACIC EPIDURAL INJ WO GUID","code_information":[{"code":"62320","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":632.64,"maximum":1897.92,"gross_charge":1977,"discounted_cash":1146.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1878.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1897.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1640.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":948.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":685.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":632.64,"methodology":"fee schedule"}]}]},{"description":"THORACIC EPIDURAL INJ W GUIDE","code_information":[{"code":"62321","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1443.21,"maximum":1897.92,"gross_charge":1977,"discounted_cash":1146.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1878.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1897.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1640.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1443.21,"methodology":"fee schedule"}]}]},{"description":"THORACIC EPIDURAL INJ W GUIDE","code_information":[{"code":"62321","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":632.64,"maximum":1897.92,"gross_charge":1977,"discounted_cash":1146.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1878.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1897.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1640.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":948.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":685.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":632.64,"methodology":"fee schedule"}]}]},{"description":"INJ LUMBAR EPIDURAL WO GUIDE","code_information":[{"code":"62322","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1443.21,"maximum":1897.92,"gross_charge":1977,"discounted_cash":1146.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1878.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1897.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1640.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1443.21,"methodology":"fee schedule"}]}]},{"description":"INJ LUMBAR EPIDURAL WO GUIDE","code_information":[{"code":"62322","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":632.64,"maximum":1897.92,"gross_charge":1977,"discounted_cash":1146.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1878.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1897.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1640.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":948.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":685.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":632.64,"methodology":"fee schedule"}]}]},{"description":"INJ LUMBAR EPIDURAL W GUIDE","code_information":[{"code":"62323","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1443.21,"maximum":1897.92,"gross_charge":1977,"discounted_cash":1146.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1878.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1897.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1640.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1443.21,"methodology":"fee schedule"}]}]},{"description":"INJ LUMBAR EPIDURAL W GUIDE","code_information":[{"code":"62323","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":632.64,"maximum":1897.92,"gross_charge":1977,"discounted_cash":1146.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1878.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1897.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1640.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1443.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":948.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":685.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":632.64,"methodology":"fee schedule"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6233","type":"APR-DRG"}],"standard_charges":[{"minimum":75253,"maximum":75253,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":75253,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6234","type":"APR-DRG"}],"standard_charges":[{"minimum":100178,"maximum":100178,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":100178,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6251","type":"APR-DRG"}],"standard_charges":[{"minimum":38252,"maximum":38252,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":38252,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6252","type":"APR-DRG"}],"standard_charges":[{"minimum":58500,"maximum":58500,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":58500,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6253","type":"APR-DRG"}],"standard_charges":[{"minimum":65772,"maximum":65772,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":65772,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6254","type":"APR-DRG"}],"standard_charges":[{"minimum":92288,"maximum":92288,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":92288,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM","code_information":[{"code":"6261","type":"APR-DRG"}],"standard_charges":[{"minimum":4470,"maximum":4470,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":4470,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM","code_information":[{"code":"6262","type":"APR-DRG"}],"standard_charges":[{"minimum":9998,"maximum":9998,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9998,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM","code_information":[{"code":"6263","type":"APR-DRG"}],"standard_charges":[{"minimum":25164,"maximum":25164,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25164,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT 2000-2499 GRAMS NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM","code_information":[{"code":"6264","type":"APR-DRG"}],"standard_charges":[{"minimum":61600,"maximum":61600,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":61600,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"KT BAG STARTER SURESTEP MEC","code_information":[{"code":"627980","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":32.04,"maximum":42.13,"gross_charge":43.88,"discounted_cash":25.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":41.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":42.13,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":32.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":32.04,"methodology":"fee schedule"}]}]},{"description":"KT BAG STARTER SURESTEP MEC","code_information":[{"code":"627980","type":"CDM"},{"code":"0270","type":"RC"}],"standard_charges":[{"minimum":14.05,"maximum":42.13,"gross_charge":43.88,"discounted_cash":25.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":41.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":42.13,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":32.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":32.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":21.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":15.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":14.05,"methodology":"fee schedule"}]}]},{"description":"KT RPLCMNT SURESTEP MEC LG VLT","code_information":[{"code":"627985","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":11.5,"maximum":15.12,"gross_charge":15.75,"discounted_cash":9.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":14.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":15.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":11.5,"methodology":"fee schedule"}]}]},{"description":"KT RPLCMNT SURESTEP MEC LG VLT","code_information":[{"code":"627985","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":5.04,"maximum":15.12,"gross_charge":15.75,"discounted_cash":9.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":14.97,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":15.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":11.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":13.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":11.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":7.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":5.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":5.04,"methodology":"fee schedule"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE","code_information":[{"code":"6301","type":"APR-DRG"}],"standard_charges":[{"minimum":57024,"maximum":57024,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":57024,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE","code_information":[{"code":"6302","type":"APR-DRG"}],"standard_charges":[{"minimum":143747,"maximum":143747,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":143747,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE","code_information":[{"code":"6303","type":"APR-DRG"}],"standard_charges":[{"minimum":226566,"maximum":226566,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":226566,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE","code_information":[{"code":"6304","type":"APR-DRG"}],"standard_charges":[{"minimum":468908,"maximum":468908,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":468908,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE","code_information":[{"code":"6311","type":"APR-DRG"}],"standard_charges":[{"minimum":11805,"maximum":11805,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11805,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE","code_information":[{"code":"6312","type":"APR-DRG"}],"standard_charges":[{"minimum":74359,"maximum":74359,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":74359,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE","code_information":[{"code":"6313","type":"APR-DRG"}],"standard_charges":[{"minimum":144899,"maximum":144899,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":144899,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE","code_information":[{"code":"6314","type":"APR-DRG"}],"standard_charges":[{"minimum":332492,"maximum":332492,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":332492,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6331","type":"APR-DRG"}],"standard_charges":[{"minimum":7322,"maximum":7322,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":7322,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6332","type":"APR-DRG"}],"standard_charges":[{"minimum":21101,"maximum":21101,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21101,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6333","type":"APR-DRG"}],"standard_charges":[{"minimum":113300,"maximum":113300,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":113300,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY","code_information":[{"code":"6334","type":"APR-DRG"}],"standard_charges":[{"minimum":206421,"maximum":206421,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":206421,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NDL ENDO T INJ 23G 5MM 230CM","code_information":[{"code":"633882","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":75.92,"maximum":99.84,"gross_charge":104,"discounted_cash":60.32,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":98.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":99.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":75.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":86.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":75.92,"methodology":"fee schedule"}]}]},{"description":"NDL ENDO T INJ 23G 5MM 230CM","code_information":[{"code":"633882","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":33.28,"maximum":99.84,"gross_charge":104,"discounted_cash":60.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":98.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":99.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":75.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":86.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":75.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":49.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":36.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":33.28,"methodology":"fee schedule"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6341","type":"APR-DRG"}],"standard_charges":[{"minimum":22836,"maximum":22836,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22836,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6342","type":"APR-DRG"}],"standard_charges":[{"minimum":42797,"maximum":42797,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":42797,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6343","type":"APR-DRG"}],"standard_charges":[{"minimum":45167,"maximum":45167,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45167,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION","code_information":[{"code":"6344","type":"APR-DRG"}],"standard_charges":[{"minimum":105022,"maximum":105022,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":105022,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6361","type":"APR-DRG"}],"standard_charges":[{"minimum":17712,"maximum":17712,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17712,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6362","type":"APR-DRG"}],"standard_charges":[{"minimum":33169,"maximum":33169,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33169,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6363","type":"APR-DRG"}],"standard_charges":[{"minimum":57181,"maximum":57181,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":57181,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION","code_information":[{"code":"6364","type":"APR-DRG"}],"standard_charges":[{"minimum":79897,"maximum":79897,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":79897,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6391","type":"APR-DRG"}],"standard_charges":[{"minimum":10381,"maximum":10381,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10381,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6392","type":"APR-DRG"}],"standard_charges":[{"minimum":22684,"maximum":22684,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22684,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6393","type":"APR-DRG"}],"standard_charges":[{"minimum":41930,"maximum":41930,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41930,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION","code_information":[{"code":"6394","type":"APR-DRG"}],"standard_charges":[{"minimum":52480,"maximum":52480,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":52480,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM","code_information":[{"code":"6401","type":"APR-DRG"}],"standard_charges":[{"minimum":3061,"maximum":3061,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":3061,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM","code_information":[{"code":"6402","type":"APR-DRG"}],"standard_charges":[{"minimum":4557,"maximum":4557,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":4557,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM","code_information":[{"code":"6403","type":"APR-DRG"}],"standard_charges":[{"minimum":10013,"maximum":10013,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10013,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NEONATE BIRTH WEIGHT > 2499 GRAMS NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM","code_information":[{"code":"6404","type":"APR-DRG"}],"standard_charges":[{"minimum":50830,"maximum":50830,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50830,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INJ PARASPINAL CERV/THORAC","code_information":[{"code":"64490","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1929.39,"maximum":2537.28,"gross_charge":2643,"discounted_cash":1532.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2510.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2537.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1929.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2193.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1929.39,"methodology":"fee schedule"}]}]},{"description":"INJ PARASPINAL CERV/THORAC","code_information":[{"code":"64490","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":845.76,"maximum":2537.28,"gross_charge":2643,"discounted_cash":1532.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2510.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2537.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1929.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2193.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1929.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1268.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":916.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":845.76,"methodology":"fee schedule"}]}]},{"description":"INJ SNGL FACET LUMBAR","code_information":[{"code":"64493","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":1929.39,"maximum":2537.28,"gross_charge":2643,"discounted_cash":1532.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2510.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2537.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1929.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2193.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1929.39,"methodology":"fee schedule"}]}]},{"description":"INJ SNGL FACET LUMBAR","code_information":[{"code":"64493","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":845.76,"maximum":2537.28,"gross_charge":2643,"discounted_cash":1532.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2510.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2537.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1929.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2193.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1929.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1268.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":916.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":845.76,"methodology":"fee schedule"}]}]},{"description":"SPLENECTOMY","code_information":[{"code":"6501","type":"APR-DRG"}],"standard_charges":[{"minimum":34308,"maximum":34308,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":34308,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPLENECTOMY","code_information":[{"code":"6502","type":"APR-DRG"}],"standard_charges":[{"minimum":43967,"maximum":43967,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43967,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPLENECTOMY","code_information":[{"code":"6503","type":"APR-DRG"}],"standard_charges":[{"minimum":66677,"maximum":66677,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":66677,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SPLENECTOMY","code_information":[{"code":"6504","type":"APR-DRG"}],"standard_charges":[{"minimum":111244,"maximum":111244,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":111244,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS","code_information":[{"code":"6511","type":"APR-DRG"}],"standard_charges":[{"minimum":25781,"maximum":25781,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25781,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS","code_information":[{"code":"6512","type":"APR-DRG"}],"standard_charges":[{"minimum":36649,"maximum":36649,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36649,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS","code_information":[{"code":"6513","type":"APR-DRG"}],"standard_charges":[{"minimum":50411,"maximum":50411,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":50411,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS","code_information":[{"code":"6514","type":"APR-DRG"}],"standard_charges":[{"minimum":124688,"maximum":124688,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":124688,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ADH TISS EXOFIN MICRO HV .5ML","code_information":[{"code":"653257","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":29.64,"maximum":38.98,"gross_charge":40.6,"discounted_cash":23.55,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.98,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.64,"methodology":"fee schedule"}]}]},{"description":"ADH TISS EXOFIN MICRO HV .5ML","code_information":[{"code":"653257","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":13,"maximum":38.98,"gross_charge":40.6,"discounted_cash":23.55,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.98,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13,"methodology":"fee schedule"}]}]},{"description":"STYLET GLIDERITE MED","code_information":[{"code":"657891","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":25.77,"maximum":33.89,"gross_charge":35.3,"discounted_cash":20.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":33.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":33.89,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":25.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":25.77,"methodology":"fee schedule"}]}]},{"description":"STYLET GLIDERITE MED","code_information":[{"code":"657891","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":11.3,"maximum":33.89,"gross_charge":35.3,"discounted_cash":20.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":33.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":33.89,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":25.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":25.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":16.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":12.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":11.3,"methodology":"fee schedule"}]}]},{"description":"MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION","code_information":[{"code":"6601","type":"APR-DRG"}],"standard_charges":[{"minimum":16609,"maximum":16609,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16609,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION","code_information":[{"code":"6602","type":"APR-DRG"}],"standard_charges":[{"minimum":19518,"maximum":19518,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19518,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION","code_information":[{"code":"6603","type":"APR-DRG"}],"standard_charges":[{"minimum":27988,"maximum":27988,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27988,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION","code_information":[{"code":"6604","type":"APR-DRG"}],"standard_charges":[{"minimum":30786,"maximum":30786,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30786,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COAGULATION AND PLATELET DISORDERS","code_information":[{"code":"6611","type":"APR-DRG"}],"standard_charges":[{"minimum":21725,"maximum":21725,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21725,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COAGULATION AND PLATELET DISORDERS","code_information":[{"code":"6612","type":"APR-DRG"}],"standard_charges":[{"minimum":28934,"maximum":28934,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28934,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COAGULATION AND PLATELET DISORDERS","code_information":[{"code":"6613","type":"APR-DRG"}],"standard_charges":[{"minimum":29484,"maximum":29484,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29484,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COAGULATION AND PLATELET DISORDERS","code_information":[{"code":"6614","type":"APR-DRG"}],"standard_charges":[{"minimum":99704,"maximum":99704,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":99704,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SICKLE CELL ANEMIA CRISIS","code_information":[{"code":"6621","type":"APR-DRG"}],"standard_charges":[{"minimum":12324,"maximum":12324,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12324,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SICKLE CELL ANEMIA CRISIS","code_information":[{"code":"6622","type":"APR-DRG"}],"standard_charges":[{"minimum":16264,"maximum":16264,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16264,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SICKLE CELL ANEMIA CRISIS","code_information":[{"code":"6623","type":"APR-DRG"}],"standard_charges":[{"minimum":27790,"maximum":27790,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27790,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SICKLE CELL ANEMIA CRISIS","code_information":[{"code":"6624","type":"APR-DRG"}],"standard_charges":[{"minimum":47230,"maximum":47230,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":47230,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS","code_information":[{"code":"6631","type":"APR-DRG"}],"standard_charges":[{"minimum":13224,"maximum":13224,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13224,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS","code_information":[{"code":"6632","type":"APR-DRG"}],"standard_charges":[{"minimum":17801,"maximum":17801,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17801,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS","code_information":[{"code":"6633","type":"APR-DRG"}],"standard_charges":[{"minimum":27960,"maximum":27960,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27960,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS","code_information":[{"code":"6634","type":"APR-DRG"}],"standard_charges":[{"minimum":45380,"maximum":45380,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":45380,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DRSNG 4X4PD OPTIFOAM BORD","code_information":[{"code":"676531","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":16.89,"maximum":22.21,"gross_charge":23.13,"discounted_cash":13.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":21.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.89,"methodology":"fee schedule"}]}]},{"description":"DRSNG 4X4PD OPTIFOAM BORD","code_information":[{"code":"676531","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":7.41,"maximum":22.21,"gross_charge":23.13,"discounted_cash":13.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":21.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":22.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":16.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":19.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":16.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":11.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":8.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.41,"methodology":"fee schedule"}]}]},{"description":"DRSNG 9X9 OPTIFOAM BORD","code_information":[{"code":"677045","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":25.73,"maximum":33.84,"gross_charge":35.24,"discounted_cash":20.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":33.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":33.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":25.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":25.73,"methodology":"fee schedule"}]}]},{"description":"DRSNG 9X9 OPTIFOAM BORD","code_information":[{"code":"677045","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":11.28,"maximum":33.84,"gross_charge":35.24,"discounted_cash":20.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":33.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":33.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":25.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":25.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":16.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":12.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":11.28,"methodology":"fee schedule"}]}]},{"description":"DRSNG 4X4 OPTIFOAM BORD","code_information":[{"code":"677047","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":75.84,"maximum":99.73,"gross_charge":103.88,"discounted_cash":60.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":98.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":99.73,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":86.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":75.84,"methodology":"fee schedule"}]}]},{"description":"DRSNG 4X4 OPTIFOAM BORD","code_information":[{"code":"677047","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":33.25,"maximum":99.73,"gross_charge":103.88,"discounted_cash":60.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":98.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":99.73,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":86.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":75.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":49.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":36.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":33.25,"methodology":"fee schedule"}]}]},{"description":"DRSNG OPTIFOAM GEN EX SACRUM","code_information":[{"code":"677172","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":21.34,"maximum":28.06,"gross_charge":29.22,"discounted_cash":16.95,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":28.06,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.34,"methodology":"fee schedule"}]}]},{"description":"DRSNG OPTIFOAM GEN EX SACRUM","code_information":[{"code":"677172","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":9.36,"maximum":28.06,"gross_charge":29.22,"discounted_cash":16.95,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":27.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":28.06,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":21.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":24.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":21.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":14.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":9.36,"methodology":"fee schedule"}]}]},{"description":"MAJOR O.R. PROCEDURES FOR LYMPHATIC HEMATOPOIETIC OR OTHER NEOPLASMS","code_information":[{"code":"6801","type":"APR-DRG"}],"standard_charges":[{"minimum":22144,"maximum":22144,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22144,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR O.R. PROCEDURES FOR LYMPHATIC HEMATOPOIETIC OR OTHER NEOPLASMS","code_information":[{"code":"6802","type":"APR-DRG"}],"standard_charges":[{"minimum":29221,"maximum":29221,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29221,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR O.R. PROCEDURES FOR LYMPHATIC HEMATOPOIETIC OR OTHER NEOPLASMS","code_information":[{"code":"6803","type":"APR-DRG"}],"standard_charges":[{"minimum":72149,"maximum":72149,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":72149,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR O.R. PROCEDURES FOR LYMPHATIC HEMATOPOIETIC OR OTHER NEOPLASMS","code_information":[{"code":"6804","type":"APR-DRG"}],"standard_charges":[{"minimum":159637,"maximum":159637,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":159637,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"TB SALEM STOMACH VLV 16FRX48IN","code_information":[{"code":"680463","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":19.3,"maximum":25.38,"gross_charge":26.43,"discounted_cash":15.33,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.3,"methodology":"fee schedule"}]}]},{"description":"TB SALEM STOMACH VLV 16FRX48IN","code_information":[{"code":"680463","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":8.46,"maximum":25.38,"gross_charge":26.43,"discounted_cash":15.33,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.46,"methodology":"fee schedule"}]}]},{"description":"OTHER  O.R. PROCEDURES FOR LYMPHATIC HEMATOPOIETIC OR OTHER NEOPLASMS","code_information":[{"code":"6811","type":"APR-DRG"}],"standard_charges":[{"minimum":23703,"maximum":23703,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23703,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER  O.R. PROCEDURES FOR LYMPHATIC HEMATOPOIETIC OR OTHER NEOPLASMS","code_information":[{"code":"6812","type":"APR-DRG"}],"standard_charges":[{"minimum":37247,"maximum":37247,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37247,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LARYNSCP MAC S4","code_information":[{"code":"681264","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":115.64,"maximum":152.07,"gross_charge":158.4,"discounted_cash":91.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":150.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":152.07,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":115.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":115.64,"methodology":"fee schedule"}]}]},{"description":"LARYNSCP MAC S4","code_information":[{"code":"681264","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":50.69,"maximum":152.07,"gross_charge":158.4,"discounted_cash":91.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":150.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":152.07,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":115.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":115.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":54.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":50.69,"methodology":"fee schedule"}]}]},{"description":"OTHER  O.R. PROCEDURES FOR LYMPHATIC HEMATOPOIETIC OR OTHER NEOPLASMS","code_information":[{"code":"6813","type":"APR-DRG"}],"standard_charges":[{"minimum":67635,"maximum":67635,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":67635,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER  O.R. PROCEDURES FOR LYMPHATIC HEMATOPOIETIC OR OTHER NEOPLASMS","code_information":[{"code":"6814","type":"APR-DRG"}],"standard_charges":[{"minimum":131355,"maximum":131355,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":131355,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SOL BSS SALT 500ML","code_information":[{"code":"683546","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":23,"maximum":30.24,"gross_charge":31.5,"discounted_cash":18.27,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":30.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":23,"methodology":"fee schedule"}]}]},{"description":"SOL BSS SALT 500ML","code_information":[{"code":"683546","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":10.08,"maximum":30.24,"gross_charge":31.5,"discounted_cash":18.27,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":29.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":30.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":26.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":15.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":10.08,"methodology":"fee schedule"}]}]},{"description":"SOL SDV MIOSTAT 1.5 ML","code_information":[{"code":"683554","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":70.08,"maximum":92.16,"gross_charge":96,"discounted_cash":55.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":91.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":92.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":70.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":70.08,"methodology":"fee schedule"}]}]},{"description":"SOL SDV MIOSTAT 1.5 ML","code_information":[{"code":"683554","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":30.72,"maximum":92.16,"gross_charge":96,"discounted_cash":55.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":91.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":92.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":70.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":70.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":46.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":33.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":30.72,"methodology":"fee schedule"}]}]},{"description":"DRSNG IOPLEX IDPHR PAD 4X5IN","code_information":[{"code":"684394","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":53.39,"maximum":70.21,"gross_charge":73.13,"discounted_cash":42.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":69.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":70.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":53.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":60.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":53.39,"methodology":"fee schedule"}]}]},{"description":"DRSNG IOPLEX IDPHR PAD 4X5IN","code_information":[{"code":"684394","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":23.41,"maximum":70.21,"gross_charge":73.13,"discounted_cash":42.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":69.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":70.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":53.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":60.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":53.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":35.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":25.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":23.41,"methodology":"fee schedule"}]}]},{"description":"TB SALEM SUMP VLV 12FR 48IN","code_information":[{"code":"686560","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":14.28,"maximum":18.78,"gross_charge":19.56,"discounted_cash":11.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":18.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":18.78,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":14.28,"methodology":"fee schedule"}]}]},{"description":"TB SALEM SUMP VLV 12FR 48IN","code_information":[{"code":"686560","type":"CDM"},{"code":"0272","type":"RC"}],"standard_charges":[{"minimum":6.26,"maximum":18.78,"gross_charge":19.56,"discounted_cash":11.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":18.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":18.78,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":14.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":9.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":6.26,"methodology":"fee schedule"}]}]},{"description":"ACUTE LEUKEMIA","code_information":[{"code":"6901","type":"APR-DRG"}],"standard_charges":[{"minimum":21957,"maximum":21957,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":21957,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE LEUKEMIA","code_information":[{"code":"6902","type":"APR-DRG"}],"standard_charges":[{"minimum":63218,"maximum":63218,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":63218,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE LEUKEMIA","code_information":[{"code":"6903","type":"APR-DRG"}],"standard_charges":[{"minimum":128425,"maximum":128425,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":128425,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE LEUKEMIA","code_information":[{"code":"6904","type":"APR-DRG"}],"standard_charges":[{"minimum":141267,"maximum":141267,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":141267,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LYMPHOMA MYELOMA AND NON-ACUTE LEUKEMIA","code_information":[{"code":"6911","type":"APR-DRG"}],"standard_charges":[{"minimum":20353,"maximum":20353,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20353,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LYMPHOMA MYELOMA AND NON-ACUTE LEUKEMIA","code_information":[{"code":"6912","type":"APR-DRG"}],"standard_charges":[{"minimum":25764,"maximum":25764,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25764,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LYMPHOMA MYELOMA AND NON-ACUTE LEUKEMIA","code_information":[{"code":"6913","type":"APR-DRG"}],"standard_charges":[{"minimum":72507,"maximum":72507,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":72507,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LYMPHOMA MYELOMA AND NON-ACUTE LEUKEMIA","code_information":[{"code":"6914","type":"APR-DRG"}],"standard_charges":[{"minimum":77320,"maximum":77320,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":77320,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RADIOTHERAPY","code_information":[{"code":"6921","type":"APR-DRG"}],"standard_charges":[{"minimum":14725,"maximum":14725,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14725,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RADIOTHERAPY","code_information":[{"code":"6922","type":"APR-DRG"}],"standard_charges":[{"minimum":23394,"maximum":23394,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23394,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RADIOTHERAPY","code_information":[{"code":"6923","type":"APR-DRG"}],"standard_charges":[{"minimum":48415,"maximum":48415,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48415,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RADIOTHERAPY","code_information":[{"code":"6924","type":"APR-DRG"}],"standard_charges":[{"minimum":86047,"maximum":86047,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":86047,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR","code_information":[{"code":"6941","type":"APR-DRG"}],"standard_charges":[{"minimum":15707,"maximum":15707,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15707,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR","code_information":[{"code":"6942","type":"APR-DRG"}],"standard_charges":[{"minimum":19423,"maximum":19423,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19423,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR","code_information":[{"code":"6943","type":"APR-DRG"}],"standard_charges":[{"minimum":32432,"maximum":32432,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32432,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR","code_information":[{"code":"6944","type":"APR-DRG"}],"standard_charges":[{"minimum":88580,"maximum":88580,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":88580,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHEMOTHERAPY FOR ACUTE LEUKEMIA","code_information":[{"code":"6951","type":"APR-DRG"}],"standard_charges":[{"minimum":14442,"maximum":14442,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14442,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHEMOTHERAPY FOR ACUTE LEUKEMIA","code_information":[{"code":"6952","type":"APR-DRG"}],"standard_charges":[{"minimum":29360,"maximum":29360,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29360,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHEMOTHERAPY FOR ACUTE LEUKEMIA","code_information":[{"code":"6953","type":"APR-DRG"}],"standard_charges":[{"minimum":64687,"maximum":64687,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":64687,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHEMOTHERAPY FOR ACUTE LEUKEMIA","code_information":[{"code":"6954","type":"APR-DRG"}],"standard_charges":[{"minimum":130383,"maximum":130383,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":130383,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CHEMOTHERAPY","code_information":[{"code":"6961","type":"APR-DRG"}],"standard_charges":[{"minimum":17009,"maximum":17009,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17009,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CHEMOTHERAPY","code_information":[{"code":"6962","type":"APR-DRG"}],"standard_charges":[{"minimum":22677,"maximum":22677,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22677,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CHEMOTHERAPY","code_information":[{"code":"6963","type":"APR-DRG"}],"standard_charges":[{"minimum":27610,"maximum":27610,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27610,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER CHEMOTHERAPY","code_information":[{"code":"6964","type":"APR-DRG"}],"standard_charges":[{"minimum":58557,"maximum":58557,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":58557,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MANDIBLE LESS 4V","code_information":[{"code":"70100","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":213.16,"maximum":280.32,"gross_charge":292,"discounted_cash":169.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":277.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":280.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":213.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":242.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":213.16,"methodology":"fee schedule"}]}]},{"description":"MANDIBLE LESS 4V","code_information":[{"code":"70100","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":93.44,"maximum":280.32,"gross_charge":292,"discounted_cash":169.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":277.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":280.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":213.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":242.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":213.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":140.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":101.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":93.44,"methodology":"fee schedule"}]}]},{"description":"MANDIBLE COMP MIN 4V","code_information":[{"code":"70110","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":274.48,"maximum":360.96,"gross_charge":376,"discounted_cash":218.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":357.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":360.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":274.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":312.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":274.48,"methodology":"fee schedule"}]}]},{"description":"MANDIBLE COMP MIN 4V","code_information":[{"code":"70110","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":120.32,"maximum":360.96,"gross_charge":376,"discounted_cash":218.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":357.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":360.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":274.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":312.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":274.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":180.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":130.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":120.32,"methodology":"fee schedule"}]}]},{"description":"FACIAL BONES LESS 3V","code_information":[{"code":"70140","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":208.78,"maximum":274.56,"gross_charge":286,"discounted_cash":165.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":271.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":274.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":208.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":237.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":208.78,"methodology":"fee schedule"}]}]},{"description":"FACIAL BONES LESS 3V","code_information":[{"code":"70140","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":91.52,"maximum":274.56,"gross_charge":286,"discounted_cash":165.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":271.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":274.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":208.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":237.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":208.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":137.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":99.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":91.52,"methodology":"fee schedule"}]}]},{"description":"FACIAL BONES COMP MIN 3V","code_information":[{"code":"70150","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":304.41,"maximum":400.32,"gross_charge":417,"discounted_cash":241.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":396.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":400.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":304.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":346.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":304.41,"methodology":"fee schedule"}]}]},{"description":"FACIAL BONES COMP MIN 3V","code_information":[{"code":"70150","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":133.44,"maximum":400.32,"gross_charge":417,"discounted_cash":241.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":396.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":400.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":304.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":346.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":304.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":200.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":144.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":133.44,"methodology":"fee schedule"}]}]},{"description":"NASAL BONE MIN 3V","code_information":[{"code":"70160","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":210.24,"maximum":276.48,"gross_charge":288,"discounted_cash":167.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":273.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":276.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":210.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":239.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":210.24,"methodology":"fee schedule"}]}]},{"description":"NASAL BONE MIN 3V","code_information":[{"code":"70160","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":92.16,"maximum":276.48,"gross_charge":288,"discounted_cash":167.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":273.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":276.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":210.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":239.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":210.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":138.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":99.88,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":92.16,"methodology":"fee schedule"}]}]},{"description":"SINUS LESS 3V","code_information":[{"code":"70210","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":158.41,"maximum":208.32,"gross_charge":217,"discounted_cash":125.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":206.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":208.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":158.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":158.41,"methodology":"fee schedule"}]}]},{"description":"SINUS LESS 3V","code_information":[{"code":"70210","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":69.44,"maximum":208.32,"gross_charge":217,"discounted_cash":125.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":206.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":208.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":158.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":158.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":104.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":75.26,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":69.44,"methodology":"fee schedule"}]}]},{"description":"SINUS COMP MIN 3V","code_information":[{"code":"70220","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":187.61,"maximum":246.72,"gross_charge":257,"discounted_cash":149.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":244.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":246.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":187.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":213.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":187.61,"methodology":"fee schedule"}]}]},{"description":"SINUS COMP MIN 3V","code_information":[{"code":"70220","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":82.24,"maximum":246.72,"gross_charge":257,"discounted_cash":149.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":244.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":246.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":187.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":213.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":187.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":123.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":89.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":82.24,"methodology":"fee schedule"}]}]},{"description":"SELLA TURCICA","code_information":[{"code":"70240","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":205.86,"maximum":270.72,"gross_charge":282,"discounted_cash":163.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":267.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":270.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":205.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":234.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":205.86,"methodology":"fee schedule"}]}]},{"description":"SELLA TURCICA","code_information":[{"code":"70240","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":90.24,"maximum":270.72,"gross_charge":282,"discounted_cash":163.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":267.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":270.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":205.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":234.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":205.86,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":135.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":97.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":90.24,"methodology":"fee schedule"}]}]},{"description":"SKULL LESS 4V","code_information":[{"code":"70250","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":227.76,"maximum":299.52,"gross_charge":312,"discounted_cash":180.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":296.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":299.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":227.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":258.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":227.76,"methodology":"fee schedule"}]}]},{"description":"SKULL LESS 4V","code_information":[{"code":"70250","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":99.84,"maximum":299.52,"gross_charge":312,"discounted_cash":180.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":296.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":299.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":227.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":258.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":227.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":149.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":108.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":99.84,"methodology":"fee schedule"}]}]},{"description":"SKULL COMP MIN 4V","code_information":[{"code":"70260","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":322.66,"maximum":424.32,"gross_charge":442,"discounted_cash":256.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":419.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":424.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":322.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":366.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":322.66,"methodology":"fee schedule"}]}]},{"description":"SKULL COMP MIN 4V","code_information":[{"code":"70260","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":141.44,"maximum":424.32,"gross_charge":442,"discounted_cash":256.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":419.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":424.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":322.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":366.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":322.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":212.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":153.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":141.44,"methodology":"fee schedule"}]}]},{"description":"TMJ OPEN AND CLOSED BI","code_information":[{"code":"70330","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":400.04,"maximum":526.08,"gross_charge":548,"discounted_cash":317.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":520.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":526.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":400.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":454.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":400.04,"methodology":"fee schedule"}]}]},{"description":"TMJ OPEN AND CLOSED BI","code_information":[{"code":"70330","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":175.36,"maximum":526.08,"gross_charge":548,"discounted_cash":317.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":520.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":526.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":400.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":454.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":400.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":263.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":190.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":175.36,"methodology":"fee schedule"}]}]},{"description":"TMJ JOINTS","code_information":[{"code":"70336","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2689.32,"maximum":3536.64,"gross_charge":3684,"discounted_cash":2136.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3499.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3536.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2689.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3057.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2689.32,"methodology":"fee schedule"}]}]},{"description":"TMJ JOINTS","code_information":[{"code":"70336","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1178.88,"maximum":3536.64,"gross_charge":3684,"discounted_cash":2136.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3499.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3536.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2689.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3057.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2689.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1768.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1277.62,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1178.88,"methodology":"fee schedule"}]}]},{"description":"NECK SOFT TISSUE","code_information":[{"code":"70360","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":243.09,"maximum":319.68,"gross_charge":333,"discounted_cash":193.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":316.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":319.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":276.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.09,"methodology":"fee schedule"}]}]},{"description":"NECK SOFT TISSUE","code_information":[{"code":"70360","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":106.56,"maximum":319.68,"gross_charge":333,"discounted_cash":193.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":316.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":319.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":276.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":159.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":115.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":106.56,"methodology":"fee schedule"}]}]},{"description":"HEAD WO CONT","code_information":[{"code":"70450","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":821.98,"maximum":1080.96,"gross_charge":1126,"discounted_cash":653.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1069.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1080.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":821.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":934.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":821.98,"methodology":"fee schedule"}]}]},{"description":"HEAD WO CONT","code_information":[{"code":"70450","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":360.32,"maximum":1080.96,"gross_charge":1126,"discounted_cash":653.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1069.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1080.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":821.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":934.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":821.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":540.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":390.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":360.32,"methodology":"fee schedule"}]}]},{"description":"HEAD W CONT","code_information":[{"code":"70460","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":1200.12,"maximum":1578.24,"gross_charge":1644,"discounted_cash":953.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1561.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1578.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1364.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1200.12,"methodology":"fee schedule"}]}]},{"description":"HEAD W CONT","code_information":[{"code":"70460","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":526.08,"maximum":1578.24,"gross_charge":1644,"discounted_cash":953.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1561.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1578.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1364.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1200.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":789.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":570.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":526.08,"methodology":"fee schedule"}]}]},{"description":"HEAD W WO CONT","code_information":[{"code":"70470","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":1446.13,"maximum":1901.76,"gross_charge":1981,"discounted_cash":1148.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1881.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1901.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1446.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1644.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1446.13,"methodology":"fee schedule"}]}]},{"description":"HEAD W WO CONT","code_information":[{"code":"70470","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":633.92,"maximum":1901.76,"gross_charge":1981,"discounted_cash":1148.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1881.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1901.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1446.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1644.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1446.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":950.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":687.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":633.92,"methodology":"fee schedule"}]}]},{"description":"ORBIT SELLA PF IAC WO CONT","code_information":[{"code":"70480","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":1920.63,"maximum":2525.76,"gross_charge":2631,"discounted_cash":1525.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2499.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2525.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1920.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2183.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1920.63,"methodology":"fee schedule"}]}]},{"description":"ORBIT SELLA PF IAC WO CONT","code_information":[{"code":"70480","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":841.92,"maximum":2525.76,"gross_charge":2631,"discounted_cash":1525.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2499.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2525.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1920.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2183.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1920.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1262.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":912.44,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":841.92,"methodology":"fee schedule"}]}]},{"description":"ORBIT SELLA PF IAC W CONT","code_information":[{"code":"70481","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":2347.68,"maximum":3087.36,"gross_charge":3216,"discounted_cash":1865.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3055.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3087.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2347.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2669.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2347.68,"methodology":"fee schedule"}]}]},{"description":"ORBIT SELLA PF IAC W CONT","code_information":[{"code":"70481","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":1029.12,"maximum":3087.36,"gross_charge":3216,"discounted_cash":1865.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3055.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3087.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2347.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2669.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2347.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1543.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1115.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1029.12,"methodology":"fee schedule"}]}]},{"description":"ORBIT SELLA PF IAC W WO CONT","code_information":[{"code":"70482","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":2204.6,"maximum":2899.2,"gross_charge":3020,"discounted_cash":1751.6,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2869,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2899.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2204.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2506.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2204.6,"methodology":"fee schedule"}]}]},{"description":"ORBIT SELLA PF IAC W WO CONT","code_information":[{"code":"70482","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":966.4,"maximum":2899.2,"gross_charge":3020,"discounted_cash":1751.6,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2869,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2899.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2204.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2506.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2204.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1449.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1047.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":966.4,"methodology":"fee schedule"}]}]},{"description":"MAX FACIAL SINUS WO CONT","code_information":[{"code":"70486","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":1152.67,"maximum":1515.84,"gross_charge":1579,"discounted_cash":915.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1500.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1515.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1152.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1310.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1152.67,"methodology":"fee schedule"}]}]},{"description":"MAX FACIAL SINUS WO CONT","code_information":[{"code":"70486","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":505.28,"maximum":1515.84,"gross_charge":1579,"discounted_cash":915.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1500.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1515.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1152.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1310.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1152.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":757.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":547.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":505.28,"methodology":"fee schedule"}]}]},{"description":"MAX FACIAL SINUS W CONT","code_information":[{"code":"70487","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":1337.36,"maximum":1758.72,"gross_charge":1832,"discounted_cash":1062.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1740.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1758.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1520.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1337.36,"methodology":"fee schedule"}]}]},{"description":"MAX FACIAL SINUS W CONT","code_information":[{"code":"70487","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":586.24,"maximum":1758.72,"gross_charge":1832,"discounted_cash":1062.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1740.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1758.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1337.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1520.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1337.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":879.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":635.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":586.24,"methodology":"fee schedule"}]}]},{"description":"MAX FACIAL SINUS W WO CONT","code_information":[{"code":"70488","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":1671.7,"maximum":2198.4,"gross_charge":2290,"discounted_cash":1328.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2175.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2198.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1671.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1900.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1671.7,"methodology":"fee schedule"}]}]},{"description":"MAX FACIAL SINUS W WO CONT","code_information":[{"code":"70488","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":732.8,"maximum":2198.4,"gross_charge":2290,"discounted_cash":1328.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2175.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2198.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1671.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1900.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1671.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1099.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":794.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":732.8,"methodology":"fee schedule"}]}]},{"description":"SOFT TISSUE NECK WO CONT","code_information":[{"code":"70490","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":1227.86,"maximum":1614.72,"gross_charge":1682,"discounted_cash":975.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1597.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1614.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1227.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1396.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1227.86,"methodology":"fee schedule"}]}]},{"description":"SOFT TISSUE NECK WO CONT","code_information":[{"code":"70490","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":538.24,"maximum":1614.72,"gross_charge":1682,"discounted_cash":975.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1597.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1614.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1227.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1396.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1227.86,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":807.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":583.32,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":538.24,"methodology":"fee schedule"}]}]},{"description":"SOFT TISSUE NECK CT W CONT","code_information":[{"code":"70491","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1594.32,"maximum":2096.64,"gross_charge":2184,"discounted_cash":1266.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2074.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2096.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1594.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1812.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1594.32,"methodology":"fee schedule"}]}]},{"description":"SOFT TISSUE NECK CT W CONT","code_information":[{"code":"70491","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":698.88,"maximum":2096.64,"gross_charge":2184,"discounted_cash":1266.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2074.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2096.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1594.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1812.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1594.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1048.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":757.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":698.88,"methodology":"fee schedule"}]}]},{"description":"SOFT TISSUE NECK W WO CONT","code_information":[{"code":"70492","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1961.51,"maximum":2579.52,"gross_charge":2687,"discounted_cash":1558.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2552.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2579.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1961.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2230.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1961.51,"methodology":"fee schedule"}]}]},{"description":"SOFT TISSUE NECK W WO CONT","code_information":[{"code":"70492","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":859.84,"maximum":2579.52,"gross_charge":2687,"discounted_cash":1558.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2552.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2579.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1961.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2230.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1961.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1289.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":931.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":859.84,"methodology":"fee schedule"}]}]},{"description":"ANG HEAD CT","code_information":[{"code":"70496","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":2453.53,"maximum":3226.56,"gross_charge":3361,"discounted_cash":1949.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3192.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3226.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2453.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2789.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2453.53,"methodology":"fee schedule"}]}]},{"description":"ANG HEAD CT","code_information":[{"code":"70496","type":"CPT"},{"code":"0351","type":"RC"}],"standard_charges":[{"minimum":1075.52,"maximum":3226.56,"gross_charge":3361,"discounted_cash":1949.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3192.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3226.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2453.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2789.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2453.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1613.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1165.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1075.52,"methodology":"fee schedule"}]}]},{"description":"ANG NECK CT","code_information":[{"code":"70498","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2308.99,"maximum":3036.48,"gross_charge":3163,"discounted_cash":1834.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3004.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3036.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2308.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2625.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2308.99,"methodology":"fee schedule"}]}]},{"description":"ANG NECK CT","code_information":[{"code":"70498","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1012.16,"maximum":3036.48,"gross_charge":3163,"discounted_cash":1834.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3004.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3036.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2308.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2625.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2308.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1518.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1096.93,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1012.16,"methodology":"fee schedule"}]}]},{"description":"FACE NECK ORBIT WO CONT","code_information":[{"code":"70540","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2203.14,"maximum":2897.28,"gross_charge":3018,"discounted_cash":1750.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2867.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2897.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2203.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2504.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2203.14,"methodology":"fee schedule"}]}]},{"description":"FACE NECK ORBIT WO CONT","code_information":[{"code":"70540","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":965.76,"maximum":2897.28,"gross_charge":3018,"discounted_cash":1750.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2867.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2897.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2203.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2504.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2203.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1448.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1046.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":965.76,"methodology":"fee schedule"}]}]},{"description":"FACE NECK ORBIT W CONT","code_information":[{"code":"70542","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1815.51,"maximum":2387.52,"gross_charge":2487,"discounted_cash":1442.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2362.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2387.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1815.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2064.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1815.51,"methodology":"fee schedule"}]}]},{"description":"FACE NECK ORBIT W CONT","code_information":[{"code":"70542","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":795.84,"maximum":2387.52,"gross_charge":2487,"discounted_cash":1442.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2362.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2387.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1815.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2064.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1815.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1193.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":862.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":795.84,"methodology":"fee schedule"}]}]},{"description":"FACE NECK ORBIT W WO CONT","code_information":[{"code":"70543","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2489.3,"maximum":3273.6,"gross_charge":3410,"discounted_cash":1977.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3239.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3273.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2489.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2830.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2489.3,"methodology":"fee schedule"}]}]},{"description":"FACE NECK ORBIT W WO CONT","code_information":[{"code":"70543","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1091.2,"maximum":3273.6,"gross_charge":3410,"discounted_cash":1977.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3239.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3273.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2489.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2830.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2489.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1636.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1182.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1091.2,"methodology":"fee schedule"}]}]},{"description":"ANG HEAD WO CONT","code_information":[{"code":"70544","type":"CPT"},{"code":"0615","type":"RC"}],"standard_charges":[{"minimum":3244.85,"maximum":4267.2,"gross_charge":4445,"discounted_cash":2578.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4222.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4267.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3244.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3689.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3244.85,"methodology":"fee schedule"}]}]},{"description":"ANG HEAD WO CONT","code_information":[{"code":"70544","type":"CPT"},{"code":"0615","type":"RC"}],"standard_charges":[{"minimum":1422.4,"maximum":4267.2,"gross_charge":4445,"discounted_cash":2578.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4222.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4267.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3244.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3689.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3244.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2133.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1541.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1422.4,"methodology":"fee schedule"}]}]},{"description":"ANG HEAD W CONT","code_information":[{"code":"70545","type":"CPT"},{"code":"0615","type":"RC"}],"standard_charges":[{"minimum":3222.22,"maximum":4237.44,"gross_charge":4414,"discounted_cash":2560.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4193.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4237.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3222.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3663.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3222.22,"methodology":"fee schedule"}]}]},{"description":"ANG HEAD W CONT","code_information":[{"code":"70545","type":"CPT"},{"code":"0615","type":"RC"}],"standard_charges":[{"minimum":1412.48,"maximum":4237.44,"gross_charge":4414,"discounted_cash":2560.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4193.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4237.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3222.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3663.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3222.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2118.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1530.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1412.48,"methodology":"fee schedule"}]}]},{"description":"ANG HEAD W WO CONT","code_information":[{"code":"70546","type":"CPT"},{"code":"0615","type":"RC"}],"standard_charges":[{"minimum":4982.25,"maximum":6552,"gross_charge":6825,"discounted_cash":3958.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6483.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6552,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4982.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5664.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4982.25,"methodology":"fee schedule"}]}]},{"description":"ANG HEAD W WO CONT","code_information":[{"code":"70546","type":"CPT"},{"code":"0615","type":"RC"}],"standard_charges":[{"minimum":2184,"maximum":6552,"gross_charge":6825,"discounted_cash":3958.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6483.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6552,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4982.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5664.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4982.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3276,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2366.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2184,"methodology":"fee schedule"}]}]},{"description":"ANG NECK WO CONT","code_information":[{"code":"70547","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2430.9,"maximum":3196.8,"gross_charge":3330,"discounted_cash":1931.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3163.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3196.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2430.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2763.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2430.9,"methodology":"fee schedule"}]}]},{"description":"ANG NECK WO CONT","code_information":[{"code":"70547","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1065.6,"maximum":3196.8,"gross_charge":3330,"discounted_cash":1931.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3163.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3196.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2430.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2763.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2430.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1598.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1154.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1065.6,"methodology":"fee schedule"}]}]},{"description":"ANG NECK W CONT","code_information":[{"code":"70548","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2430.9,"maximum":3196.8,"gross_charge":3330,"discounted_cash":1931.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3163.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3196.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2430.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2763.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2430.9,"methodology":"fee schedule"}]}]},{"description":"ANG NECK W CONT","code_information":[{"code":"70548","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1065.6,"maximum":3196.8,"gross_charge":3330,"discounted_cash":1931.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3163.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3196.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2430.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2763.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2430.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1598.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1154.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1065.6,"methodology":"fee schedule"}]}]},{"description":"ANG NECK W WO CONT","code_information":[{"code":"70549","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2860.87,"maximum":3762.24,"gross_charge":3919,"discounted_cash":2273.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3723.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3762.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2860.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3252.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2860.87,"methodology":"fee schedule"}]}]},{"description":"ANG NECK W WO CONT","code_information":[{"code":"70549","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1254.08,"maximum":3762.24,"gross_charge":3919,"discounted_cash":2273.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3723.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3762.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2860.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3252.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2860.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1881.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1359.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1254.08,"methodology":"fee schedule"}]}]},{"description":"BRAIN WO CONT","code_information":[{"code":"70551","type":"CPT"},{"code":"0611","type":"RC"}],"standard_charges":[{"minimum":2052.03,"maximum":2698.56,"gross_charge":2811,"discounted_cash":1630.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2670.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2698.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2052.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2333.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2052.03,"methodology":"fee schedule"}]}]},{"description":"BRAIN WO CONT","code_information":[{"code":"70551","type":"CPT"},{"code":"0611","type":"RC"}],"standard_charges":[{"minimum":899.52,"maximum":2698.56,"gross_charge":2811,"discounted_cash":1630.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2670.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2698.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2052.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2333.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2052.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1349.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":974.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":899.52,"methodology":"fee schedule"}]}]},{"description":"BRAIN W CONT","code_information":[{"code":"70552","type":"CPT"},{"code":"0611","type":"RC"}],"standard_charges":[{"minimum":3036.07,"maximum":3992.64,"gross_charge":4159,"discounted_cash":2412.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3951.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3992.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3036.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3451.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3036.07,"methodology":"fee schedule"}]}]},{"description":"BRAIN W CONT","code_information":[{"code":"70552","type":"CPT"},{"code":"0611","type":"RC"}],"standard_charges":[{"minimum":1330.88,"maximum":3992.64,"gross_charge":4159,"discounted_cash":2412.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3951.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3992.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3036.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3451.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3036.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1996.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1442.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1330.88,"methodology":"fee schedule"}]}]},{"description":"BRAIN W WO CONT","code_information":[{"code":"70553","type":"CPT"},{"code":"0611","type":"RC"}],"standard_charges":[{"minimum":3425.89,"maximum":4505.28,"gross_charge":4693,"discounted_cash":2721.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4458.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4505.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3425.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3895.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3425.89,"methodology":"fee schedule"}]}]},{"description":"BRAIN W WO CONT","code_information":[{"code":"70553","type":"CPT"},{"code":"0611","type":"RC"}],"standard_charges":[{"minimum":1501.76,"maximum":4505.28,"gross_charge":4693,"discounted_cash":2721.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4458.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4505.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3425.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3895.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3425.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2252.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1627.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1501.76,"methodology":"fee schedule"}]}]},{"description":"INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE","code_information":[{"code":"7101","type":"APR-DRG"}],"standard_charges":[{"minimum":22627,"maximum":22627,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22627,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE","code_information":[{"code":"7102","type":"APR-DRG"}],"standard_charges":[{"minimum":33977,"maximum":33977,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":33977,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE","code_information":[{"code":"7103","type":"APR-DRG"}],"standard_charges":[{"minimum":48389,"maximum":48389,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48389,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE","code_information":[{"code":"7104","type":"APR-DRG"}],"standard_charges":[{"minimum":108457,"maximum":108457,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":108457,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHEST 1V FRONTAL","code_information":[{"code":"71045","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":173.01,"maximum":227.52,"gross_charge":237,"discounted_cash":137.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":225.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":227.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":173.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":196.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":173.01,"methodology":"fee schedule"}]}]},{"description":"CHEST 1V FRONTAL","code_information":[{"code":"71045","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":75.84,"maximum":227.52,"gross_charge":237,"discounted_cash":137.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":225.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":227.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":173.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":196.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":173.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":113.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":82.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":75.84,"methodology":"fee schedule"}]}]},{"description":"CHEST 2V","code_information":[{"code":"71046","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":224.84,"maximum":295.68,"gross_charge":308,"discounted_cash":178.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":295.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":224.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":255.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":224.84,"methodology":"fee schedule"}]}]},{"description":"CHEST 2V","code_information":[{"code":"71046","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":98.56,"maximum":295.68,"gross_charge":308,"discounted_cash":178.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":295.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":224.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":255.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":224.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":147.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":106.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":98.56,"methodology":"fee schedule"}]}]},{"description":"CHEST DECUBITUS BI","code_information":[{"code":"71046","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":240.9,"maximum":316.8,"gross_charge":330,"discounted_cash":191.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":313.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":316.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.9,"methodology":"fee schedule"}]}]},{"description":"CHEST DECUBITUS BI","code_information":[{"code":"71046","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":105.6,"maximum":316.8,"gross_charge":330,"discounted_cash":191.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":313.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":316.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":240.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":273.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":240.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":114.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":105.6,"methodology":"fee schedule"}]}]},{"description":"CHEST 2V W APICAL LORDOTIC","code_information":[{"code":"71047","type":"CPT"},{"code":"0324","type":"RC"}],"standard_charges":[{"minimum":271.56,"maximum":357.12,"gross_charge":372,"discounted_cash":215.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":353.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":357.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":308.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":271.56,"methodology":"fee schedule"}]}]},{"description":"CHEST 2V W APICAL LORDOTIC","code_information":[{"code":"71047","type":"CPT"},{"code":"0324","type":"RC"}],"standard_charges":[{"minimum":119.04,"maximum":357.12,"gross_charge":372,"discounted_cash":215.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":353.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":357.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":308.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":178.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":129.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"}]}]},{"description":"CHEST 2V W OBLIQUES","code_information":[{"code":"71048","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":224.84,"maximum":295.68,"gross_charge":308,"discounted_cash":178.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":295.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":224.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":255.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":224.84,"methodology":"fee schedule"}]}]},{"description":"CHEST 2V W OBLIQUES","code_information":[{"code":"71048","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":98.56,"maximum":295.68,"gross_charge":308,"discounted_cash":178.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":292.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":295.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":224.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":255.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":224.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":147.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":106.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":98.56,"methodology":"fee schedule"}]}]},{"description":"CHEST MIN 4V","code_information":[{"code":"71048","type":"CPT"},{"code":"0324","type":"RC"}],"standard_charges":[{"minimum":285.43,"maximum":375.36,"gross_charge":391,"discounted_cash":226.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":371.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":375.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":285.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":324.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":285.43,"methodology":"fee schedule"}]}]},{"description":"CHEST MIN 4V","code_information":[{"code":"71048","type":"CPT"},{"code":"0324","type":"RC"}],"standard_charges":[{"minimum":125.12,"maximum":375.36,"gross_charge":391,"discounted_cash":226.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":371.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":375.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":285.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":324.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":285.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":187.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":135.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":125.12,"methodology":"fee schedule"}]}]},{"description":"POST-OPERATIVE POST-TRAUMA OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE","code_information":[{"code":"7111","type":"APR-DRG"}],"standard_charges":[{"minimum":22479,"maximum":22479,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22479,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"RIBS 3V WO CHEST BI","code_information":[{"code":"71110","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":337.99,"maximum":444.48,"gross_charge":463,"discounted_cash":268.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":439.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":444.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":337.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":384.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":337.99,"methodology":"fee schedule"}]}]},{"description":"RIBS 3V WO CHEST BI","code_information":[{"code":"71110","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":148.16,"maximum":444.48,"gross_charge":463,"discounted_cash":268.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":439.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":444.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":337.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":384.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":337.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":222.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":160.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":148.16,"methodology":"fee schedule"}]}]},{"description":"RIBS 3V W CHEST BI","code_information":[{"code":"71111","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":362.81,"maximum":477.12,"gross_charge":497,"discounted_cash":288.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":472.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":477.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":362.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":412.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":362.81,"methodology":"fee schedule"}]}]},{"description":"RIBS 3V W CHEST BI","code_information":[{"code":"71111","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":159.04,"maximum":477.12,"gross_charge":497,"discounted_cash":288.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":472.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":477.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":362.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":412.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":362.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":238.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":172.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":159.04,"methodology":"fee schedule"}]}]},{"description":"POST-OPERATIVE POST-TRAUMA OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE","code_information":[{"code":"7112","type":"APR-DRG"}],"standard_charges":[{"minimum":29392,"maximum":29392,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29392,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STERNUM MIN 2V","code_information":[{"code":"71120","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":192.72,"maximum":253.44,"gross_charge":264,"discounted_cash":153.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":250.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":253.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":192.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":219.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":192.72,"methodology":"fee schedule"}]}]},{"description":"STERNUM MIN 2V","code_information":[{"code":"71120","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":84.48,"maximum":253.44,"gross_charge":264,"discounted_cash":153.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":250.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":253.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":192.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":219.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":192.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":126.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":91.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":84.48,"methodology":"fee schedule"}]}]},{"description":"POST-OPERATIVE POST-TRAUMA OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE","code_information":[{"code":"7113","type":"APR-DRG"}],"standard_charges":[{"minimum":61909,"maximum":61909,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":61909,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"STENOCLAVICULAR JOINT","code_information":[{"code":"71130","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":310.98,"maximum":408.96,"gross_charge":426,"discounted_cash":247.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":404.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":408.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":310.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":353.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":310.98,"methodology":"fee schedule"}]}]},{"description":"STENOCLAVICULAR JOINT","code_information":[{"code":"71130","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":136.32,"maximum":408.96,"gross_charge":426,"discounted_cash":247.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":404.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":408.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":310.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":353.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":310.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":204.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":147.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":136.32,"methodology":"fee schedule"}]}]},{"description":"POST-OPERATIVE POST-TRAUMA OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE","code_information":[{"code":"7114","type":"APR-DRG"}],"standard_charges":[{"minimum":98217,"maximum":98217,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":98217,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CHEST WO CONT","code_information":[{"code":"71250","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1246.11,"maximum":1638.72,"gross_charge":1707,"discounted_cash":990.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1621.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1638.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1246.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1416.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1246.11,"methodology":"fee schedule"}]}]},{"description":"CHEST WO CONT","code_information":[{"code":"71250","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":546.24,"maximum":1638.72,"gross_charge":1707,"discounted_cash":990.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1621.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1638.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1246.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1416.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1246.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":819.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":591.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":546.24,"methodology":"fee schedule"}]}]},{"description":"CHEST CT W CONT","code_information":[{"code":"71260","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1576.8,"maximum":2073.6,"gross_charge":2160,"discounted_cash":1252.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2052,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2073.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1576.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1792.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1576.8,"methodology":"fee schedule"}]}]},{"description":"CHEST CT W CONT","code_information":[{"code":"71260","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":691.2,"maximum":2073.6,"gross_charge":2160,"discounted_cash":1252.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2052,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2073.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1576.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1792.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1576.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1036.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":749.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":691.2,"methodology":"fee schedule"}]}]},{"description":"CHEST W WO CONT","code_information":[{"code":"71270","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1955.67,"maximum":2571.84,"gross_charge":2679,"discounted_cash":1553.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2545.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2571.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1955.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2223.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1955.67,"methodology":"fee schedule"}]}]},{"description":"CHEST W WO CONT","code_information":[{"code":"71270","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":857.28,"maximum":2571.84,"gross_charge":2679,"discounted_cash":1553.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2545.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2571.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1955.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2223.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1955.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1285.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":929.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":857.28,"methodology":"fee schedule"}]}]},{"description":"LUNG SCREEN PROTOCOL","code_information":[{"code":"71271","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":914.69,"maximum":1202.88,"gross_charge":1253,"discounted_cash":726.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1190.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1202.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":914.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1039.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":914.69,"methodology":"fee schedule"}]}]},{"description":"LUNG SCREEN PROTOCOL","code_information":[{"code":"71271","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":400.96,"maximum":1202.88,"gross_charge":1253,"discounted_cash":726.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1190.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1202.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":914.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1039.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":914.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":601.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":434.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":400.96,"methodology":"fee schedule"}]}]},{"description":"ANG CHEST","code_information":[{"code":"71275","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2353.52,"maximum":3095.04,"gross_charge":3224,"discounted_cash":1869.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3062.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3095.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2353.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2675.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2353.52,"methodology":"fee schedule"}]}]},{"description":"ANG CHEST","code_information":[{"code":"71275","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1031.68,"maximum":3095.04,"gross_charge":3224,"discounted_cash":1869.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3062.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3095.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2353.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2675.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2353.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1547.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1118.09,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1031.68,"methodology":"fee schedule"}]}]},{"description":"CHEST WO CONT","code_information":[{"code":"71550","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2560.11,"maximum":3366.72,"gross_charge":3507,"discounted_cash":2034.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3331.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3366.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2560.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2910.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2560.11,"methodology":"fee schedule"}]}]},{"description":"CHEST WO CONT","code_information":[{"code":"71550","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1122.24,"maximum":3366.72,"gross_charge":3507,"discounted_cash":2034.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3331.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3366.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2560.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2910.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2560.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1683.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1216.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1122.24,"methodology":"fee schedule"}]}]},{"description":"CHEST W CONT","code_information":[{"code":"71551","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2811.23,"maximum":3696.96,"gross_charge":3851,"discounted_cash":2233.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3658.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3696.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2811.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3196.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2811.23,"methodology":"fee schedule"}]}]},{"description":"CHEST W CONT","code_information":[{"code":"71551","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1232.32,"maximum":3696.96,"gross_charge":3851,"discounted_cash":2233.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3658.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3696.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2811.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3196.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2811.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1848.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1335.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1232.32,"methodology":"fee schedule"}]}]},{"description":"CHEST W WO CONT","code_information":[{"code":"71552","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":3677.01,"maximum":4835.52,"gross_charge":5037,"discounted_cash":2921.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4785.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4835.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3677.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4180.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3677.01,"methodology":"fee schedule"}]}]},{"description":"CHEST W WO CONT","code_information":[{"code":"71552","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1611.84,"maximum":4835.52,"gross_charge":5037,"discounted_cash":2921.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4785.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4835.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3677.01,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":4180.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3677.01,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2417.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1746.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1611.84,"methodology":"fee schedule"}]}]},{"description":"SEPTICEMIA AND DISSEMINATED INFECTIONS","code_information":[{"code":"7201","type":"APR-DRG"}],"standard_charges":[{"minimum":12779,"maximum":12779,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12779,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SEPTICEMIA AND DISSEMINATED INFECTIONS","code_information":[{"code":"7202","type":"APR-DRG"}],"standard_charges":[{"minimum":16590,"maximum":16590,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":16590,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CERVICAL SPINE 1V","code_information":[{"code":"72020","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":159.14,"maximum":209.28,"gross_charge":218,"discounted_cash":126.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":207.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":209.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":159.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":159.14,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE 1V","code_information":[{"code":"72020","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":69.76,"maximum":209.28,"gross_charge":218,"discounted_cash":126.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":207.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":209.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":159.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":180.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":159.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":104.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":75.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":69.76,"methodology":"fee schedule"}]}]},{"description":"SEPTICEMIA AND DISSEMINATED INFECTIONS","code_information":[{"code":"7203","type":"APR-DRG"}],"standard_charges":[{"minimum":26599,"maximum":26599,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26599,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SEPTICEMIA AND DISSEMINATED INFECTIONS","code_information":[{"code":"7204","type":"APR-DRG"}],"standard_charges":[{"minimum":75155,"maximum":75155,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":75155,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CERVICAL SPINE 2V OR 3V","code_information":[{"code":"72040","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":259.15,"maximum":340.8,"gross_charge":355,"discounted_cash":205.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":337.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":340.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":259.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":294.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":259.15,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE 2V OR 3V","code_information":[{"code":"72040","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":113.6,"maximum":340.8,"gross_charge":355,"discounted_cash":205.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":337.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":340.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":259.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":294.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":259.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":123.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":113.6,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE COMP W OBLIQUES","code_information":[{"code":"72050","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":432.16,"maximum":568.32,"gross_charge":592,"discounted_cash":343.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":562.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":568.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":432.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":491.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":432.16,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE COMP W OBLIQUES","code_information":[{"code":"72050","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":189.44,"maximum":568.32,"gross_charge":592,"discounted_cash":343.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":562.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":568.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":432.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":491.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":432.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":284.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":205.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":189.44,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE W FLEX AND EXT","code_information":[{"code":"72052","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":447.49,"maximum":588.48,"gross_charge":613,"discounted_cash":355.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":582.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":588.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":447.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":508.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":447.49,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE W FLEX AND EXT","code_information":[{"code":"72052","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":196.16,"maximum":588.48,"gross_charge":613,"discounted_cash":355.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":582.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":588.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":447.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":508.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":447.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":294.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":212.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":196.16,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE 2V","code_information":[{"code":"72070","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":194.18,"maximum":255.36,"gross_charge":266,"discounted_cash":154.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":252.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":255.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":194.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":220.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":194.18,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE 2V","code_information":[{"code":"72070","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":85.12,"maximum":255.36,"gross_charge":266,"discounted_cash":154.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":252.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":255.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":194.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":220.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":194.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":127.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":92.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":85.12,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE 3V","code_information":[{"code":"72072","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":281.05,"maximum":369.6,"gross_charge":385,"discounted_cash":223.3,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":365.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":369.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":281.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":319.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":281.05,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE 3V","code_information":[{"code":"72072","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":123.2,"maximum":369.6,"gross_charge":385,"discounted_cash":223.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":365.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":369.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":281.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":319.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":281.05,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":184.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":133.52,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":123.2,"methodology":"fee schedule"}]}]},{"description":"THORACOLUMBAR 2V","code_information":[{"code":"72080","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":247.47,"maximum":325.44,"gross_charge":339,"discounted_cash":196.62,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":322.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":325.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":247.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":281.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":247.47,"methodology":"fee schedule"}]}]},{"description":"THORACOLUMBAR 2V","code_information":[{"code":"72080","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":108.48,"maximum":325.44,"gross_charge":339,"discounted_cash":196.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":322.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":325.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":247.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":281.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":247.47,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":162.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":117.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":108.48,"methodology":"fee schedule"}]}]},{"description":"SPINE SCOLIOSIS STAND - 1 V","code_information":[{"code":"72081","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":155.49,"maximum":204.48,"gross_charge":213,"discounted_cash":123.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":202.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":204.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":155.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":176.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":155.49,"methodology":"fee schedule"}]}]},{"description":"SPINE SCOLIOSIS STAND - 1 V","code_information":[{"code":"72081","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":68.16,"maximum":204.48,"gross_charge":213,"discounted_cash":123.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":202.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":204.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":155.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":176.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":155.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":102.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":73.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":68.16,"methodology":"fee schedule"}]}]},{"description":"SPINE SCOLIOSIS STAND 2-3 V","code_information":[{"code":"72082","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":285.43,"maximum":375.36,"gross_charge":391,"discounted_cash":226.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":371.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":375.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":285.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":324.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":285.43,"methodology":"fee schedule"}]}]},{"description":"SPINE SCOLIOSIS STAND 2-3 V","code_information":[{"code":"72082","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":125.12,"maximum":375.36,"gross_charge":391,"discounted_cash":226.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":371.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":375.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":285.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":324.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":285.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":187.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":135.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":125.12,"methodology":"fee schedule"}]}]},{"description":"SPINE SCOLIOSIS STAND 4-5 V","code_information":[{"code":"72083","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":457.71,"maximum":601.92,"gross_charge":627,"discounted_cash":363.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":595.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":601.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":457.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":520.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":457.71,"methodology":"fee schedule"}]}]},{"description":"SPINE SCOLIOSIS STAND 4-5 V","code_information":[{"code":"72083","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":200.64,"maximum":601.92,"gross_charge":627,"discounted_cash":363.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":595.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":601.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":457.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":520.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":457.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":300.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":217.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":200.64,"methodology":"fee schedule"}]}]},{"description":"SPINE SCOLIOSIS STAND MIN 6","code_information":[{"code":"72084","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":471.58,"maximum":620.16,"gross_charge":646,"discounted_cash":374.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":613.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":620.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":471.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":536.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":471.58,"methodology":"fee schedule"}]}]},{"description":"SPINE SCOLIOSIS STAND MIN 6","code_information":[{"code":"72084","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":206.72,"maximum":620.16,"gross_charge":646,"discounted_cash":374.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":613.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":620.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":471.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":536.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":471.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":310.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":224.04,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":206.72,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE 2 OR 3V","code_information":[{"code":"72100","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":295.65,"maximum":388.8,"gross_charge":405,"discounted_cash":234.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":384.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":388.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":295.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":336.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":295.65,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE 2 OR 3V","code_information":[{"code":"72100","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":129.6,"maximum":388.8,"gross_charge":405,"discounted_cash":234.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":384.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":388.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":295.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":336.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":295.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":194.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":140.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":129.6,"methodology":"fee schedule"}]}]},{"description":"POST-OPERATIVE POST-TRAUMATIC OTHER DEVICE INFECTIONS","code_information":[{"code":"7211","type":"APR-DRG"}],"standard_charges":[{"minimum":13816,"maximum":13816,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13816,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"LUMBAR SPINE MIN 4V","code_information":[{"code":"72110","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":423.4,"maximum":556.8,"gross_charge":580,"discounted_cash":336.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":551,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":556.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":423.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":481.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":423.4,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE MIN 4V","code_information":[{"code":"72110","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":185.6,"maximum":556.8,"gross_charge":580,"discounted_cash":336.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":551,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":556.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":423.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":481.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":423.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":278.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":201.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":185.6,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE COMP W OBL BEND","code_information":[{"code":"72114","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":419.75,"maximum":552,"gross_charge":575,"discounted_cash":333.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":546.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":552,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":419.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":477.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":419.75,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE COMP W OBL BEND","code_information":[{"code":"72114","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":184,"maximum":552,"gross_charge":575,"discounted_cash":333.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":546.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":552,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":419.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":477.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":419.75,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":276,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":199.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":184,"methodology":"fee schedule"}]}]},{"description":"POST-OPERATIVE POST-TRAUMATIC OTHER DEVICE INFECTIONS","code_information":[{"code":"7212","type":"APR-DRG"}],"standard_charges":[{"minimum":17114,"maximum":17114,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17114,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CERVICAL SPINE WO CONT","code_information":[{"code":"72125","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1659.29,"maximum":2182.08,"gross_charge":2273,"discounted_cash":1318.34,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2159.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2182.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1659.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1886.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1659.29,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE WO CONT","code_information":[{"code":"72125","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":727.36,"maximum":2182.08,"gross_charge":2273,"discounted_cash":1318.34,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2159.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2182.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1659.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1886.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1659.29,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1091.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":788.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":727.36,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE W CONT","code_information":[{"code":"72126","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2106.78,"maximum":2770.56,"gross_charge":2886,"discounted_cash":1673.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2741.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2770.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2106.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2395.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2106.78,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE W CONT","code_information":[{"code":"72126","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":923.52,"maximum":2770.56,"gross_charge":2886,"discounted_cash":1673.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2741.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2770.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2106.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2395.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2106.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1385.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1000.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":923.52,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE W WO CONT","code_information":[{"code":"72127","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2587.85,"maximum":3403.2,"gross_charge":3545,"discounted_cash":2056.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3367.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3403.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2587.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2942.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2587.85,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE W WO CONT","code_information":[{"code":"72127","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1134.4,"maximum":3403.2,"gross_charge":3545,"discounted_cash":2056.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3367.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3403.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2587.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2942.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2587.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1701.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1229.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1134.4,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE WO CONT","code_information":[{"code":"72128","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1461.46,"maximum":1921.92,"gross_charge":2002,"discounted_cash":1161.16,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1901.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1921.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1461.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1661.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1461.46,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE WO CONT","code_information":[{"code":"72128","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":640.64,"maximum":1921.92,"gross_charge":2002,"discounted_cash":1161.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1901.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1921.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1461.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1661.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1461.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":960.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":694.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":640.64,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE W CONT","code_information":[{"code":"72129","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1896.54,"maximum":2494.08,"gross_charge":2598,"discounted_cash":1506.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2468.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2494.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1896.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2156.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1896.54,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE W CONT","code_information":[{"code":"72129","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":831.36,"maximum":2494.08,"gross_charge":2598,"discounted_cash":1506.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2468.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2494.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1896.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2156.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1896.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1247.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":900.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":831.36,"methodology":"fee schedule"}]}]},{"description":"POST-OPERATIVE POST-TRAUMATIC OTHER DEVICE INFECTIONS","code_information":[{"code":"7213","type":"APR-DRG"}],"standard_charges":[{"minimum":29829,"maximum":29829,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29829,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"THORACIC SPINE W WO CONT","code_information":[{"code":"72130","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2348.41,"maximum":3088.32,"gross_charge":3217,"discounted_cash":1865.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3056.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3088.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2348.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2670.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2348.41,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE W WO CONT","code_information":[{"code":"72130","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1029.44,"maximum":3088.32,"gross_charge":3217,"discounted_cash":1865.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3056.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3088.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2348.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2670.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2348.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1544.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1115.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1029.44,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE WO CONT","code_information":[{"code":"72131","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1454.16,"maximum":1912.32,"gross_charge":1992,"discounted_cash":1155.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1892.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1912.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1454.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1653.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1454.16,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE WO CONT","code_information":[{"code":"72131","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":637.44,"maximum":1912.32,"gross_charge":1992,"discounted_cash":1155.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1892.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1912.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1454.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1653.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1454.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":956.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":690.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":637.44,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE W CONT","code_information":[{"code":"72132","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1890.7,"maximum":2486.4,"gross_charge":2590,"discounted_cash":1502.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2460.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2486.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1890.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2149.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1890.7,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE W CONT","code_information":[{"code":"72132","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":828.8,"maximum":2486.4,"gross_charge":2590,"discounted_cash":1502.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2460.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2486.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1890.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2149.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1890.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1243.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":898.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":828.8,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE W WO CONT","code_information":[{"code":"72133","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2327.24,"maximum":3060.48,"gross_charge":3188,"discounted_cash":1849.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3028.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3060.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2327.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2646.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2327.24,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE W WO CONT","code_information":[{"code":"72133","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1020.16,"maximum":3060.48,"gross_charge":3188,"discounted_cash":1849.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3028.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3060.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2327.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2646.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2327.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1530.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1105.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1020.16,"methodology":"fee schedule"}]}]},{"description":"POST-OPERATIVE POST-TRAUMATIC OTHER DEVICE INFECTIONS","code_information":[{"code":"7214","type":"APR-DRG"}],"standard_charges":[{"minimum":43482,"maximum":43482,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43482,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"CERVICAL SPINE COMP WO CONT","code_information":[{"code":"72141","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":1933.77,"maximum":2543.04,"gross_charge":2649,"discounted_cash":1536.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2516.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2543.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1933.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2198.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1933.77,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE COMP WO CONT","code_information":[{"code":"72141","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":847.68,"maximum":2543.04,"gross_charge":2649,"discounted_cash":1536.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2516.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2543.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1933.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2198.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1933.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1271.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":918.68,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":847.68,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE COMP W CONT","code_information":[{"code":"72142","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":2920,"maximum":3840,"gross_charge":4000,"discounted_cash":2320,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3800,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3840,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2920,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3320,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2920,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE COMP W CONT","code_information":[{"code":"72142","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":1280,"maximum":3840,"gross_charge":4000,"discounted_cash":2320,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3800,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3840,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2920,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3320,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2920,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1920,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1387.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1280,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE COMP WO CONT","code_information":[{"code":"72146","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":1843.98,"maximum":2424.96,"gross_charge":2526,"discounted_cash":1465.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2399.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2424.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1843.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2096.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1843.98,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE COMP WO CONT","code_information":[{"code":"72146","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":808.32,"maximum":2424.96,"gross_charge":2526,"discounted_cash":1465.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2399.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2424.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1843.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2096.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1843.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1212.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":876.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":808.32,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE LTD WO CONT","code_information":[{"code":"72146","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1843.98,"maximum":2424.96,"gross_charge":2526,"discounted_cash":1465.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2399.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2424.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1843.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2096.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1843.98,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE LTD WO CONT","code_information":[{"code":"72146","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":808.32,"maximum":2424.96,"gross_charge":2526,"discounted_cash":1465.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2399.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2424.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1843.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2096.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1843.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1212.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":876.02,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":808.32,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE COMP W CONT","code_information":[{"code":"72147","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":2600.26,"maximum":3419.52,"gross_charge":3562,"discounted_cash":2065.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3383.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3419.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2600.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2956.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2600.26,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE COMP W CONT","code_information":[{"code":"72147","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":1139.84,"maximum":3419.52,"gross_charge":3562,"discounted_cash":2065.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3383.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3419.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2600.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2956.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2600.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1709.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1235.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1139.84,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE COMP WO CONT","code_information":[{"code":"72148","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":1882.67,"maximum":2475.84,"gross_charge":2579,"discounted_cash":1495.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2450.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2475.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1882.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2140.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1882.67,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE COMP WO CONT","code_information":[{"code":"72148","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":825.28,"maximum":2475.84,"gross_charge":2579,"discounted_cash":1495.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2450.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2475.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1882.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2140.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1882.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1237.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":894.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":825.28,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE COMP W CONT","code_information":[{"code":"72149","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":2636.03,"maximum":3466.56,"gross_charge":3611,"discounted_cash":2094.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3466.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2636.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2997.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2636.03,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE COMP W CONT","code_information":[{"code":"72149","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":1155.52,"maximum":3466.56,"gross_charge":3611,"discounted_cash":2094.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3430.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3466.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2636.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2997.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2636.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1733.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1252.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1155.52,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE COMP W WO CONT","code_information":[{"code":"72156","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":3268.21,"maximum":4297.92,"gross_charge":4477,"discounted_cash":2596.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4253.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4297.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3268.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3715.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3268.21,"methodology":"fee schedule"}]}]},{"description":"CERVICAL SPINE COMP W WO CONT","code_information":[{"code":"72156","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":1432.64,"maximum":4297.92,"gross_charge":4477,"discounted_cash":2596.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4253.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4297.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3268.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3715.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3268.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2148.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1552.63,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1432.64,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE COMP W WO CONT","code_information":[{"code":"72157","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":2932.41,"maximum":3856.32,"gross_charge":4017,"discounted_cash":2329.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3816.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3856.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2932.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3334.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2932.41,"methodology":"fee schedule"}]}]},{"description":"THORACIC SPINE COMP W WO CONT","code_information":[{"code":"72157","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":1285.44,"maximum":3856.32,"gross_charge":4017,"discounted_cash":2329.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3816.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3856.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2932.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3334.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2932.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1928.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1393.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1285.44,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE COMP W WO CONT","code_information":[{"code":"72158","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":3011.98,"maximum":3960.96,"gross_charge":4126,"discounted_cash":2393.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3919.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3960.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3011.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3424.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3011.98,"methodology":"fee schedule"}]}]},{"description":"LUMBAR SPINE COMP W WO CONT","code_information":[{"code":"72158","type":"CPT"},{"code":"0612","type":"RC"}],"standard_charges":[{"minimum":1320.32,"maximum":3960.96,"gross_charge":4126,"discounted_cash":2393.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3919.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3960.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3011.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3424.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3011.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1980.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1430.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1320.32,"methodology":"fee schedule"}]}]},{"description":"PELVIS 1V OR 2V","code_information":[{"code":"72170","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":162.06,"maximum":213.12,"gross_charge":222,"discounted_cash":128.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":210.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":213.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":162.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":184.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":162.06,"methodology":"fee schedule"}]}]},{"description":"PELVIS 1V OR 2V","code_information":[{"code":"72170","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":71.04,"maximum":213.12,"gross_charge":222,"discounted_cash":128.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":210.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":213.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":162.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":184.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":162.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":106.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":76.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"}]}]},{"description":"PELVIS MIN 3V","code_information":[{"code":"72190","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":218.27,"maximum":287.04,"gross_charge":299,"discounted_cash":173.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":284.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":287.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":218.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":248.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":218.27,"methodology":"fee schedule"}]}]},{"description":"PELVIS MIN 3V","code_information":[{"code":"72190","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":95.68,"maximum":287.04,"gross_charge":299,"discounted_cash":173.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":284.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":287.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":218.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":248.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":218.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":143.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":103.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":95.68,"methodology":"fee schedule"}]}]},{"description":"ANG PELVIS","code_information":[{"code":"72191","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2451.34,"maximum":3223.68,"gross_charge":3358,"discounted_cash":1947.64,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3190.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3223.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2451.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2787.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2451.34,"methodology":"fee schedule"}]}]},{"description":"ANG PELVIS","code_information":[{"code":"72191","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1074.56,"maximum":3223.68,"gross_charge":3358,"discounted_cash":1947.64,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3190.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3223.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2451.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2787.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2451.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1611.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1164.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1074.56,"methodology":"fee schedule"}]}]},{"description":"PELVIS WO CONT","code_information":[{"code":"72192","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1034.41,"maximum":1360.32,"gross_charge":1417,"discounted_cash":821.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1346.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1360.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1034.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1176.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1034.41,"methodology":"fee schedule"}]}]},{"description":"PELVIS WO CONT","code_information":[{"code":"72192","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":453.44,"maximum":1360.32,"gross_charge":1417,"discounted_cash":821.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1346.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1360.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1034.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1176.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1034.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":680.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":491.42,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":453.44,"methodology":"fee schedule"}]}]},{"description":"PELVIS W CONT","code_information":[{"code":"72193","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1882.67,"maximum":2475.84,"gross_charge":2579,"discounted_cash":1495.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2450.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2475.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1882.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2140.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1882.67,"methodology":"fee schedule"}]}]},{"description":"PELVIS W CONT","code_information":[{"code":"72193","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":825.28,"maximum":2475.84,"gross_charge":2579,"discounted_cash":1495.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2450.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2475.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1882.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2140.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1882.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1237.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":894.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":825.28,"methodology":"fee schedule"}]}]},{"description":"PELVIS W WO CONT","code_information":[{"code":"72194","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2244.75,"maximum":2952,"gross_charge":3075,"discounted_cash":1783.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2921.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2952,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2244.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2552.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2244.75,"methodology":"fee schedule"}]}]},{"description":"PELVIS W WO CONT","code_information":[{"code":"72194","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":984,"maximum":2952,"gross_charge":3075,"discounted_cash":1783.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2921.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2952,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2244.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2552.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2244.75,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1476,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1066.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":984,"methodology":"fee schedule"}]}]},{"description":"PELVIS WO CONT","code_information":[{"code":"72195","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1948.37,"maximum":2562.24,"gross_charge":2669,"discounted_cash":1548.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2535.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2562.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1948.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2215.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1948.37,"methodology":"fee schedule"}]}]},{"description":"PELVIS WO CONT","code_information":[{"code":"72195","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":854.08,"maximum":2562.24,"gross_charge":2669,"discounted_cash":1548.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2535.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2562.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1948.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2215.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1948.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1281.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":925.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":854.08,"methodology":"fee schedule"}]}]},{"description":"PELVIS W CONT","code_information":[{"code":"72196","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2376.88,"maximum":3125.76,"gross_charge":3256,"discounted_cash":1888.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3093.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3125.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2376.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2702.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2376.88,"methodology":"fee schedule"}]}]},{"description":"PELVIS W CONT","code_information":[{"code":"72196","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1041.92,"maximum":3125.76,"gross_charge":3256,"discounted_cash":1888.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3093.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3125.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2376.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2702.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2376.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1562.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1129.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1041.92,"methodology":"fee schedule"}]}]},{"description":"PELVIS W WO CONT","code_information":[{"code":"72197","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":3175.5,"maximum":4176,"gross_charge":4350,"discounted_cash":2523,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4132.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4176,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3175.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3610.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3175.5,"methodology":"fee schedule"}]}]},{"description":"PELVIS W WO CONT","code_information":[{"code":"72197","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1392,"maximum":4176,"gross_charge":4350,"discounted_cash":2523,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4132.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4176,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3175.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3610.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3175.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2088,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1508.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1392,"methodology":"fee schedule"}]}]},{"description":"SACROILIAC JOINT 2V","code_information":[{"code":"72200","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":248.2,"maximum":326.4,"gross_charge":340,"discounted_cash":197.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":323,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":326.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":248.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":282.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":248.2,"methodology":"fee schedule"}]}]},{"description":"SACROILIAC JOINT 2V","code_information":[{"code":"72200","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":108.8,"maximum":326.4,"gross_charge":340,"discounted_cash":197.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":323,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":326.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":248.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":282.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":248.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":163.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":117.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":108.8,"methodology":"fee schedule"}]}]},{"description":"SACROILIAC JOINT MIN 3V","code_information":[{"code":"72202","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":248.2,"maximum":326.4,"gross_charge":340,"discounted_cash":197.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":323,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":326.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":248.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":282.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":248.2,"methodology":"fee schedule"}]}]},{"description":"SACROILIAC JOINT MIN 3V","code_information":[{"code":"72202","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":108.8,"maximum":326.4,"gross_charge":340,"discounted_cash":197.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":323,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":326.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":248.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":282.2,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":248.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":163.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":117.92,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":108.8,"methodology":"fee schedule"}]}]},{"description":"FEVER AND INFLAMMATORY CONDITIONS","code_information":[{"code":"7221","type":"APR-DRG"}],"standard_charges":[{"minimum":9355,"maximum":9355,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9355,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEVER AND INFLAMMATORY CONDITIONS","code_information":[{"code":"7222","type":"APR-DRG"}],"standard_charges":[{"minimum":13055,"maximum":13055,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13055,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SACRUM","code_information":[{"code":"72220","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":243.09,"maximum":319.68,"gross_charge":333,"discounted_cash":193.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":316.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":319.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":276.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.09,"methodology":"fee schedule"}]}]},{"description":"SACRUM","code_information":[{"code":"72220","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":106.56,"maximum":319.68,"gross_charge":333,"discounted_cash":193.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":316.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":319.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":276.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":159.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":115.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":106.56,"methodology":"fee schedule"}]}]},{"description":"FEVER AND INFLAMMATORY CONDITIONS","code_information":[{"code":"7223","type":"APR-DRG"}],"standard_charges":[{"minimum":17212,"maximum":17212,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17212,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FEVER AND INFLAMMATORY CONDITIONS","code_information":[{"code":"7224","type":"APR-DRG"}],"standard_charges":[{"minimum":26342,"maximum":26342,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26342,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VIRAL ILLNESS","code_information":[{"code":"7231","type":"APR-DRG"}],"standard_charges":[{"minimum":7539,"maximum":7539,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":7539,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VIRAL ILLNESS","code_information":[{"code":"7232","type":"APR-DRG"}],"standard_charges":[{"minimum":17007,"maximum":17007,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17007,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VIRAL ILLNESS","code_information":[{"code":"7233","type":"APR-DRG"}],"standard_charges":[{"minimum":17983,"maximum":17983,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17983,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VIRAL ILLNESS","code_information":[{"code":"7234","type":"APR-DRG"}],"standard_charges":[{"minimum":37749,"maximum":37749,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37749,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER INFECTIOUS AND PARASITIC DISEASES","code_information":[{"code":"7241","type":"APR-DRG"}],"standard_charges":[{"minimum":9359,"maximum":9359,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":9359,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER INFECTIOUS AND PARASITIC DISEASES","code_information":[{"code":"7242","type":"APR-DRG"}],"standard_charges":[{"minimum":17916,"maximum":17916,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17916,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER INFECTIOUS AND PARASITIC DISEASES","code_information":[{"code":"7243","type":"APR-DRG"}],"standard_charges":[{"minimum":29988,"maximum":29988,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29988,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER INFECTIOUS AND PARASITIC DISEASES","code_information":[{"code":"7244","type":"APR-DRG"}],"standard_charges":[{"minimum":58194,"maximum":58194,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":58194,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"AC JOINT W WEIGHT BI","code_information":[{"code":"73050","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":226.3,"maximum":297.6,"gross_charge":310,"discounted_cash":179.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":294.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":297.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":226.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":257.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":226.3,"methodology":"fee schedule"}]}]},{"description":"AC JOINT W WEIGHT BI","code_information":[{"code":"73050","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":99.2,"maximum":297.6,"gross_charge":310,"discounted_cash":179.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":294.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":297.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":226.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":257.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":226.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":148.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":107.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":99.2,"methodology":"fee schedule"}]}]},{"description":"UPPER EXTREMITY WO CONT BI","code_information":[{"code":"73200","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1573.88,"maximum":2069.76,"gross_charge":2156,"discounted_cash":1250.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2048.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2069.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1573.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1789.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1573.88,"methodology":"fee schedule"}]}]},{"description":"UPPER EXTREMITY WO CONT BI","code_information":[{"code":"73200","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":689.92,"maximum":2069.76,"gross_charge":2156,"discounted_cash":1250.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2048.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2069.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1573.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1789.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1573.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1034.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":747.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":689.92,"methodology":"fee schedule"}]}]},{"description":"UPPER EXTREMITY WO CONT LT","code_information":[{"code":"73200","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1537.38,"maximum":2021.76,"gross_charge":2106,"discounted_cash":1221.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2000.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2021.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1537.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1747.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1537.38,"methodology":"fee schedule"}]}]},{"description":"UPPER EXTREMITY WO CONT LT","code_information":[{"code":"73200","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":673.92,"maximum":2021.76,"gross_charge":2106,"discounted_cash":1221.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2000.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2021.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1537.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1747.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1537.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1010.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":730.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":673.92,"methodology":"fee schedule"}]}]},{"description":"UPPER EXTREMITY W CONT BI","code_information":[{"code":"73201","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1976.11,"maximum":2598.72,"gross_charge":2707,"discounted_cash":1570.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2571.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2598.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1976.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2246.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1976.11,"methodology":"fee schedule"}]}]},{"description":"UPPER EXTREMITY W CONT BI","code_information":[{"code":"73201","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":866.24,"maximum":2598.72,"gross_charge":2707,"discounted_cash":1570.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2571.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2598.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1976.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2246.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1976.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1299.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":938.79,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":866.24,"methodology":"fee schedule"}]}]},{"description":"UPPER EXTREMITY W CONT LT","code_information":[{"code":"73201","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1957.86,"maximum":2574.72,"gross_charge":2682,"discounted_cash":1555.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2547.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2574.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1957.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2226.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1957.86,"methodology":"fee schedule"}]}]},{"description":"UPPER EXTREMITY W CONT LT","code_information":[{"code":"73201","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":858.24,"maximum":2574.72,"gross_charge":2682,"discounted_cash":1555.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2547.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2574.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1957.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2226.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1957.86,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1287.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":930.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":858.24,"methodology":"fee schedule"}]}]},{"description":"UPR EXT NON JOINT W WO CONT BI","code_information":[{"code":"73220","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":4990.28,"maximum":6562.56,"gross_charge":6836,"discounted_cash":3964.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6494.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6562.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4990.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5673.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4990.28,"methodology":"fee schedule"}]}]},{"description":"UPR EXT NON JOINT W WO CONT BI","code_information":[{"code":"73220","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2187.52,"maximum":6562.56,"gross_charge":6836,"discounted_cash":3964.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6494.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6562.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4990.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5673.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4990.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3281.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2370.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2187.52,"methodology":"fee schedule"}]}]},{"description":"UPR EXT NON JOINT W WO CONT LT","code_information":[{"code":"73220","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":3328.07,"maximum":4376.64,"gross_charge":4559,"discounted_cash":2644.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4331.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4376.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3328.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3783.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3328.07,"methodology":"fee schedule"}]}]},{"description":"UPR EXT NON JOINT W WO CONT LT","code_information":[{"code":"73220","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1458.88,"maximum":4376.64,"gross_charge":4559,"discounted_cash":2644.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4331.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4376.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3328.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3783.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3328.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2188.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1581.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1458.88,"methodology":"fee schedule"}]}]},{"description":"UPR EXT JOINT WO CONT BI","code_information":[{"code":"73221","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2284.17,"maximum":3003.84,"gross_charge":3129,"discounted_cash":1814.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2972.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3003.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2284.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2597.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2284.17,"methodology":"fee schedule"}]}]},{"description":"UPR EXT JOINT WO CONT BI","code_information":[{"code":"73221","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1001.28,"maximum":3003.84,"gross_charge":3129,"discounted_cash":1814.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2972.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3003.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2284.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2597.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2284.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1501.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1085.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1001.28,"methodology":"fee schedule"}]}]},{"description":"UPR EXT JOINT WO CONT LT","code_information":[{"code":"73221","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1672.43,"maximum":2199.36,"gross_charge":2291,"discounted_cash":1328.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2176.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2199.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1672.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1901.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1672.43,"methodology":"fee schedule"}]}]},{"description":"UPR EXT JOINT WO CONT LT","code_information":[{"code":"73221","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":733.12,"maximum":2199.36,"gross_charge":2291,"discounted_cash":1328.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2176.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2199.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1672.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1901.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1672.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1099.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":794.52,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":733.12,"methodology":"fee schedule"}]}]},{"description":"UPR EXT JOINT WO CONT RT","code_information":[{"code":"73221","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1529.35,"maximum":2011.2,"gross_charge":2095,"discounted_cash":1215.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1990.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2011.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1529.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1738.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1529.35,"methodology":"fee schedule"}]}]},{"description":"UPR EXT JOINT WO CONT RT","code_information":[{"code":"73221","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":670.4,"maximum":2011.2,"gross_charge":2095,"discounted_cash":1215.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1990.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2011.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1529.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1738.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1529.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1005.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":726.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":670.4,"methodology":"fee schedule"}]}]},{"description":"UPR EXT JOINT W WO CONT BI","code_information":[{"code":"73223","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":4996.12,"maximum":6570.24,"gross_charge":6844,"discounted_cash":3969.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6501.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6570.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4996.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5680.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4996.12,"methodology":"fee schedule"}]}]},{"description":"UPR EXT JOINT W WO CONT BI","code_information":[{"code":"73223","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2190.08,"maximum":6570.24,"gross_charge":6844,"discounted_cash":3969.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6501.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6570.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4996.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5680.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4996.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3285.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2373.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2190.08,"methodology":"fee schedule"}]}]},{"description":"UPR EXT JOINT W WO CONT LT","code_information":[{"code":"73223","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":3323.69,"maximum":4370.88,"gross_charge":4553,"discounted_cash":2640.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4325.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4370.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3323.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3778.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3323.69,"methodology":"fee schedule"}]}]},{"description":"UPR EXT JOINT W WO CONT LT","code_information":[{"code":"73223","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1456.96,"maximum":4370.88,"gross_charge":4553,"discounted_cash":2640.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4325.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4370.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3323.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3778.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3323.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2185.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1578.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1456.96,"methodology":"fee schedule"}]}]},{"description":"HIP MIN 2 VIEW BI","code_information":[{"code":"73521","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":271.56,"maximum":357.12,"gross_charge":372,"discounted_cash":215.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":353.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":357.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":308.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":271.56,"methodology":"fee schedule"}]}]},{"description":"HIP MIN 2 VIEW BI","code_information":[{"code":"73521","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":119.04,"maximum":357.12,"gross_charge":372,"discounted_cash":215.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":353.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":357.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":308.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":178.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":129.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"}]}]},{"description":"HIP MIN 2 VIEW W/PELVIS BI","code_information":[{"code":"73521","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":259.15,"maximum":340.8,"gross_charge":355,"discounted_cash":205.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":337.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":340.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":259.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":294.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":259.15,"methodology":"fee schedule"}]}]},{"description":"HIP MIN 2 VIEW W/PELVIS BI","code_information":[{"code":"73521","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":113.6,"maximum":340.8,"gross_charge":355,"discounted_cash":205.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":337.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":340.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":259.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":294.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":259.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":123.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":113.6,"methodology":"fee schedule"}]}]},{"description":"HIP MIN 3-4 VIEW BI","code_information":[{"code":"73522","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":259.15,"maximum":340.8,"gross_charge":355,"discounted_cash":205.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":337.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":340.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":259.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":294.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":259.15,"methodology":"fee schedule"}]}]},{"description":"HIP MIN 3-4 VIEW BI","code_information":[{"code":"73522","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":113.6,"maximum":340.8,"gross_charge":355,"discounted_cash":205.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":337.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":340.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":259.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":294.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":259.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":170.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":123.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":113.6,"methodology":"fee schedule"}]}]},{"description":"HIP MIN 3-4 VIEW W/PLVS BI","code_information":[{"code":"73522","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":271.56,"maximum":357.12,"gross_charge":372,"discounted_cash":215.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":353.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":357.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":308.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":271.56,"methodology":"fee schedule"}]}]},{"description":"HIP MIN 3-4 VIEW W/PLVS BI","code_information":[{"code":"73522","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":119.04,"maximum":357.12,"gross_charge":372,"discounted_cash":215.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":353.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":357.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":308.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":271.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":178.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":129.01,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"}]}]},{"description":"HIP MIN 5 VIEW BI","code_information":[{"code":"73523","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":489.83,"maximum":644.16,"gross_charge":671,"discounted_cash":389.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":637.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":644.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":489.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":556.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":489.83,"methodology":"fee schedule"}]}]},{"description":"HIP MIN 5 VIEW BI","code_information":[{"code":"73523","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":214.72,"maximum":644.16,"gross_charge":671,"discounted_cash":389.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":637.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":644.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":489.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":556.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":489.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":322.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":232.71,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":214.72,"methodology":"fee schedule"}]}]},{"description":"FEMUR MIN 1 VIEW BI","code_information":[{"code":"73551","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":165.71,"maximum":217.92,"gross_charge":227,"discounted_cash":131.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":215.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":188.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.71,"methodology":"fee schedule"}]}]},{"description":"FEMUR MIN 1 VIEW BI","code_information":[{"code":"73551","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":72.64,"maximum":217.92,"gross_charge":227,"discounted_cash":131.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":215.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":188.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.64,"methodology":"fee schedule"}]}]},{"description":"FEMUR MIN 2 VIEW BI","code_information":[{"code":"73552","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":165.71,"maximum":217.92,"gross_charge":227,"discounted_cash":131.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":215.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":188.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.71,"methodology":"fee schedule"}]}]},{"description":"FEMUR MIN 2 VIEW BI","code_information":[{"code":"73552","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":72.64,"maximum":217.92,"gross_charge":227,"discounted_cash":131.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":215.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":188.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.64,"methodology":"fee schedule"}]}]},{"description":"KNEE STANDING AP BI","code_information":[{"code":"73565","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":205.13,"maximum":269.76,"gross_charge":281,"discounted_cash":162.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":266.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":269.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":205.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":233.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":205.13,"methodology":"fee schedule"}]}]},{"description":"KNEE STANDING AP BI","code_information":[{"code":"73565","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":89.92,"maximum":269.76,"gross_charge":281,"discounted_cash":162.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":266.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":269.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":205.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":233.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":205.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":134.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":97.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":89.92,"methodology":"fee schedule"}]}]},{"description":"ARTHROGRAM KNEE BI","code_information":[{"code":"73580","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":835.12,"maximum":1098.24,"gross_charge":1144,"discounted_cash":663.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1086.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1098.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":835.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":949.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":835.12,"methodology":"fee schedule"}]}]},{"description":"ARTHROGRAM KNEE BI","code_information":[{"code":"73580","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":366.08,"maximum":1098.24,"gross_charge":1144,"discounted_cash":663.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1086.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1098.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":835.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":949.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":835.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":549.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":396.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":366.08,"methodology":"fee schedule"}]}]},{"description":"BONE LENGTH STUDY","code_information":[{"code":"73700","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1454.16,"maximum":1912.32,"gross_charge":1992,"discounted_cash":1155.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1892.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1912.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1454.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1653.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1454.16,"methodology":"fee schedule"}]}]},{"description":"BONE LENGTH STUDY","code_information":[{"code":"73700","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":637.44,"maximum":1912.32,"gross_charge":1992,"discounted_cash":1155.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1892.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1912.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1454.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1653.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1454.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":956.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":690.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":637.44,"methodology":"fee schedule"}]}]},{"description":"LOWER EXTREMITY WO CONT BI","code_information":[{"code":"73700","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1541.03,"maximum":2026.56,"gross_charge":2111,"discounted_cash":1224.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2005.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2026.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1541.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1752.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1541.03,"methodology":"fee schedule"}]}]},{"description":"LOWER EXTREMITY WO CONT BI","code_information":[{"code":"73700","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":675.52,"maximum":2026.56,"gross_charge":2111,"discounted_cash":1224.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2005.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2026.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1541.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1752.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1541.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1013.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":732.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":675.52,"methodology":"fee schedule"}]}]},{"description":"LOWER EXTREMITY W CONT BI","code_information":[{"code":"73701","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1978.3,"maximum":2601.6,"gross_charge":2710,"discounted_cash":1571.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2574.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2601.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1978.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2249.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1978.3,"methodology":"fee schedule"}]}]},{"description":"LOWER EXTREMITY W CONT BI","code_information":[{"code":"73701","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":867.2,"maximum":2601.6,"gross_charge":2710,"discounted_cash":1571.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2574.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2601.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1978.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2249.3,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1978.3,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1300.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":939.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":867.2,"methodology":"fee schedule"}]}]},{"description":"LOWER EXTREMITY W CONT LT","code_information":[{"code":"73701","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1890.7,"maximum":2486.4,"gross_charge":2590,"discounted_cash":1502.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2460.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2486.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1890.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2149.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1890.7,"methodology":"fee schedule"}]}]},{"description":"LOWER EXTREMITY W CONT LT","code_information":[{"code":"73701","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":828.8,"maximum":2486.4,"gross_charge":2590,"discounted_cash":1502.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2460.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2486.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1890.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2149.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1890.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1243.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":898.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":828.8,"methodology":"fee schedule"}]}]},{"description":"LOWER EXTREMITY W WO CONT BI","code_information":[{"code":"73702","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":4813.62,"maximum":6330.24,"gross_charge":6594,"discounted_cash":3824.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6264.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6330.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4813.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5473.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4813.62,"methodology":"fee schedule"}]}]},{"description":"LOWER EXTREMITY W WO CONT BI","code_information":[{"code":"73702","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2110.08,"maximum":6330.24,"gross_charge":6594,"discounted_cash":3824.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":6264.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":6330.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":4813.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":5473.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":4813.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3165.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2286.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2110.08,"methodology":"fee schedule"}]}]},{"description":"LOWER EXTREMITY W WO CONT LT","code_information":[{"code":"73702","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2414.11,"maximum":3174.72,"gross_charge":3307,"discounted_cash":1918.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3141.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3174.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2414.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2744.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2414.11,"methodology":"fee schedule"}]}]},{"description":"LOWER EXTREMITY W WO CONT LT","code_information":[{"code":"73702","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1058.24,"maximum":3174.72,"gross_charge":3307,"discounted_cash":1918.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3141.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3174.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2414.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2744.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2414.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1587.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1146.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1058.24,"methodology":"fee schedule"}]}]},{"description":"LWR EXT NON JOINT WO CONT LT","code_information":[{"code":"73718","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2004.58,"maximum":2636.16,"gross_charge":2746,"discounted_cash":1592.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2608.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2636.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2004.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2279.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2004.58,"methodology":"fee schedule"}]}]},{"description":"LWR EXT NON JOINT WO CONT LT","code_information":[{"code":"73718","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":878.72,"maximum":2636.16,"gross_charge":2746,"discounted_cash":1592.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2608.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2636.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2004.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2279.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2004.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1318.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":952.32,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":878.72,"methodology":"fee schedule"}]}]},{"description":"LWR EXT NON JOINT WO CONT RT","code_information":[{"code":"73718","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1543.22,"maximum":2029.44,"gross_charge":2114,"discounted_cash":1226.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2008.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2029.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1543.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1754.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1543.22,"methodology":"fee schedule"}]}]},{"description":"LWR EXT NON JOINT WO CONT RT","code_information":[{"code":"73718","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":676.48,"maximum":2029.44,"gross_charge":2114,"discounted_cash":1226.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2008.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2029.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1543.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1754.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1543.22,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1014.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":733.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":676.48,"methodology":"fee schedule"}]}]},{"description":"LWR EXT NON JOINT W WO CONT RT","code_information":[{"code":"73720","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":3406.91,"maximum":4480.32,"gross_charge":4667,"discounted_cash":2706.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4433.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4480.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3406.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3873.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3406.91,"methodology":"fee schedule"}]}]},{"description":"LWR EXT NON JOINT W WO CONT RT","code_information":[{"code":"73720","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1493.44,"maximum":4480.32,"gross_charge":4667,"discounted_cash":2706.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4433.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4480.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3406.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3873.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3406.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2240.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1618.52,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1493.44,"methodology":"fee schedule"}]}]},{"description":"LWR EXT JOINT WO CONT BI","code_information":[{"code":"73721","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2121.38,"maximum":2789.76,"gross_charge":2906,"discounted_cash":1685.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2760.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2789.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2121.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2411.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2121.38,"methodology":"fee schedule"}]}]},{"description":"LWR EXT JOINT WO CONT BI","code_information":[{"code":"73721","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":929.92,"maximum":2789.76,"gross_charge":2906,"discounted_cash":1685.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2760.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2789.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2121.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2411.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2121.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1394.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1007.81,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":929.92,"methodology":"fee schedule"}]}]},{"description":"LWR EXT JOINT WO CONT LT","code_information":[{"code":"73721","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2040.35,"maximum":2683.2,"gross_charge":2795,"discounted_cash":1621.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2655.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2683.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2040.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2319.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2040.35,"methodology":"fee schedule"}]}]},{"description":"LWR EXT JOINT WO CONT LT","code_information":[{"code":"73721","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":894.4,"maximum":2683.2,"gross_charge":2795,"discounted_cash":1621.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2655.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2683.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2040.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2319.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2040.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1341.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":969.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":894.4,"methodology":"fee schedule"}]}]},{"description":"ACHILLES W CONT LT","code_information":[{"code":"73722","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2896.64,"maximum":3809.28,"gross_charge":3968,"discounted_cash":2301.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3769.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3809.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2896.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3293.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2896.64,"methodology":"fee schedule"}]}]},{"description":"ACHILLES W CONT LT","code_information":[{"code":"73722","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1269.76,"maximum":3809.28,"gross_charge":3968,"discounted_cash":2301.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3769.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3809.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2896.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3293.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2896.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1904.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1376.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1269.76,"methodology":"fee schedule"}]}]},{"description":"ACHILLES W WO CONT LT","code_information":[{"code":"73723","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":3039.72,"maximum":3997.44,"gross_charge":4164,"discounted_cash":2415.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3955.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3997.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3039.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3456.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3039.72,"methodology":"fee schedule"}]}]},{"description":"ACHILLES W WO CONT LT","code_information":[{"code":"73723","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1332.48,"maximum":3997.44,"gross_charge":4164,"discounted_cash":2415.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3955.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3997.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3039.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3456.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3039.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1998.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1444.08,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1332.48,"methodology":"fee schedule"}]}]},{"description":"MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE","code_information":[{"code":"7401","type":"APR-DRG"}],"standard_charges":[{"minimum":29658,"maximum":29658,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29658,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABDOMEN 1V DECUBITIS","code_information":[{"code":"74018","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":270.83,"maximum":356.16,"gross_charge":371,"discounted_cash":215.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":352.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":356.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":270.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":307.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":270.83,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN 1V DECUBITIS","code_information":[{"code":"74018","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":118.72,"maximum":356.16,"gross_charge":371,"discounted_cash":215.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":352.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":356.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":270.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":307.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":270.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":178.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":128.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":118.72,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN 2V AP FLAT UPRIGHT","code_information":[{"code":"74019","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":243.82,"maximum":320.64,"gross_charge":334,"discounted_cash":193.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":317.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":320.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":277.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.82,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN 2V AP FLAT UPRIGHT","code_information":[{"code":"74019","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":106.88,"maximum":320.64,"gross_charge":334,"discounted_cash":193.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":317.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":320.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":277.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":115.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":106.88,"methodology":"fee schedule"}]}]},{"description":"MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE","code_information":[{"code":"7402","type":"APR-DRG"}],"standard_charges":[{"minimum":42204,"maximum":42204,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":42204,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABDOMEN 2V AP UPRIGHT DECUB","code_information":[{"code":"74021","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":409.53,"maximum":538.56,"gross_charge":561,"discounted_cash":325.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":532.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":538.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":409.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":465.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":409.53,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN 2V AP UPRIGHT DECUB","code_information":[{"code":"74021","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":179.52,"maximum":538.56,"gross_charge":561,"discounted_cash":325.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":532.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":538.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":409.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":465.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":409.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":269.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":194.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":179.52,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN 3V COMP UPRIGHT DECUB","code_information":[{"code":"74021","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":243.82,"maximum":320.64,"gross_charge":334,"discounted_cash":193.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":317.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":320.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":277.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.82,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN 3V COMP UPRIGHT DECUB","code_information":[{"code":"74021","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":106.88,"maximum":320.64,"gross_charge":334,"discounted_cash":193.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":317.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":320.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":277.22,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":160.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":115.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":106.88,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN SERIES W CHEST 1V","code_information":[{"code":"74022","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":409.53,"maximum":538.56,"gross_charge":561,"discounted_cash":325.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":532.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":538.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":409.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":465.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":409.53,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN SERIES W CHEST 1V","code_information":[{"code":"74022","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":179.52,"maximum":538.56,"gross_charge":561,"discounted_cash":325.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":532.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":538.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":409.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":465.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":409.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":269.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":194.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":179.52,"methodology":"fee schedule"}]}]},{"description":"MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE","code_information":[{"code":"7403","type":"APR-DRG"}],"standard_charges":[{"minimum":61587,"maximum":61587,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":61587,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE","code_information":[{"code":"7404","type":"APR-DRG"}],"standard_charges":[{"minimum":147093,"maximum":147093,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":147093,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ABDOMEN WO CONT","code_information":[{"code":"74150","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1067.99,"maximum":1404.48,"gross_charge":1463,"discounted_cash":848.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1389.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1404.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1067.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1214.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1067.99,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN WO CONT","code_information":[{"code":"74150","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":468.16,"maximum":1404.48,"gross_charge":1463,"discounted_cash":848.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1389.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1404.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1067.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1214.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1067.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":702.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":507.37,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":468.16,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN W CONT","code_information":[{"code":"74160","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1987.06,"maximum":2613.12,"gross_charge":2722,"discounted_cash":1578.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2585.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2613.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1987.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2259.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1987.06,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN W CONT","code_information":[{"code":"74160","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":871.04,"maximum":2613.12,"gross_charge":2722,"discounted_cash":1578.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2585.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2613.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1987.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2259.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1987.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1306.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":943.99,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":871.04,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN W WO CONT","code_information":[{"code":"74170","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2284.9,"maximum":3004.8,"gross_charge":3130,"discounted_cash":1815.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2973.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3004.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2284.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2597.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2284.9,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN W WO CONT","code_information":[{"code":"74170","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1001.6,"maximum":3004.8,"gross_charge":3130,"discounted_cash":1815.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2973.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3004.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2284.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2597.9,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2284.9,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1502.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1085.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1001.6,"methodology":"fee schedule"}]}]},{"description":"CTA ABD PELV W CONT","code_information":[{"code":"74174","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2599.53,"maximum":3418.56,"gross_charge":3561,"discounted_cash":2065.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3382.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3418.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2599.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2955.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2599.53,"methodology":"fee schedule"}]}]},{"description":"CTA ABD PELV W CONT","code_information":[{"code":"74174","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1139.52,"maximum":3418.56,"gross_charge":3561,"discounted_cash":2065.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3382.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3418.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2599.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2955.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2599.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1709.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1234.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1139.52,"methodology":"fee schedule"}]}]},{"description":"ANG ABDOMEN","code_information":[{"code":"74175","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2448.42,"maximum":3219.84,"gross_charge":3354,"discounted_cash":1945.32,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3186.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3219.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2448.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2783.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2448.42,"methodology":"fee schedule"}]}]},{"description":"ANG ABDOMEN","code_information":[{"code":"74175","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1073.28,"maximum":3219.84,"gross_charge":3354,"discounted_cash":1945.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3186.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3219.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2448.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2783.82,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2448.42,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1609.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1163.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1073.28,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN PELVIS WO CONT","code_information":[{"code":"74176","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1505.26,"maximum":1979.52,"gross_charge":2062,"discounted_cash":1195.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1958.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1979.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1505.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1711.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1505.26,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN PELVIS WO CONT","code_information":[{"code":"74176","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":659.84,"maximum":1979.52,"gross_charge":2062,"discounted_cash":1195.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1958.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1979.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1505.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1711.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1505.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":989.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":715.11,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":659.84,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN PELVIS CT W CONT","code_information":[{"code":"74177","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":2894.45,"maximum":3806.4,"gross_charge":3965,"discounted_cash":2299.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3766.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3806.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2894.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3290.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2894.45,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN PELVIS CT W CONT","code_information":[{"code":"74177","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1268.8,"maximum":3806.4,"gross_charge":3965,"discounted_cash":2299.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3766.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3806.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2894.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3290.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2894.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1903.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1375.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1268.8,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN PELVIS W WO CONT","code_information":[{"code":"74178","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":3357.27,"maximum":4415.04,"gross_charge":4599,"discounted_cash":2667.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4369.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4415.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3357.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3817.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3357.27,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN PELVIS W WO CONT","code_information":[{"code":"74178","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1471.68,"maximum":4415.04,"gross_charge":4599,"discounted_cash":2667.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4369.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4415.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3357.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3817.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3357.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2207.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1594.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1471.68,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN WO CONT","code_information":[{"code":"74181","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1273.12,"maximum":1674.24,"gross_charge":1744,"discounted_cash":1011.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1656.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1674.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1273.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1447.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1273.12,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN WO CONT","code_information":[{"code":"74181","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":558.08,"maximum":1674.24,"gross_charge":1744,"discounted_cash":1011.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1656.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1674.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1273.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1447.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1273.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":837.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":604.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":558.08,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN W CONT","code_information":[{"code":"74182","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2406.81,"maximum":3165.12,"gross_charge":3297,"discounted_cash":1912.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3132.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3165.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2406.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2736.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2406.81,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN W CONT","code_information":[{"code":"74182","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1055.04,"maximum":3165.12,"gross_charge":3297,"discounted_cash":1912.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3132.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3165.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2406.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2736.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2406.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1582.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1143.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1055.04,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN W WO CONT","code_information":[{"code":"74183","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2766.7,"maximum":3638.4,"gross_charge":3790,"discounted_cash":2198.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3600.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3638.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2766.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3145.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2766.7,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN W WO CONT","code_information":[{"code":"74183","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1212.8,"maximum":3638.4,"gross_charge":3790,"discounted_cash":2198.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3600.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3638.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2766.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3145.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2766.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1819.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1314.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1212.8,"methodology":"fee schedule"}]}]},{"description":"ANG ABDOMEN W CONT","code_information":[{"code":"74185","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":2768.16,"maximum":3640.32,"gross_charge":3792,"discounted_cash":2199.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3602.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3640.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2768.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3147.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2768.16,"methodology":"fee schedule"}]}]},{"description":"ANG ABDOMEN W CONT","code_information":[{"code":"74185","type":"CPT"},{"code":"0610","type":"RC"}],"standard_charges":[{"minimum":1213.44,"maximum":3640.32,"gross_charge":3792,"discounted_cash":2199.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3602.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3640.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2768.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3147.36,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2768.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1820.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1315.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1213.44,"methodology":"fee schedule"}]}]},{"description":"ESOPHAGUS","code_information":[{"code":"74220","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":432.89,"maximum":569.28,"gross_charge":593,"discounted_cash":343.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":563.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":569.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":432.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":492.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":432.89,"methodology":"fee schedule"}]}]},{"description":"ESOPHAGUS","code_information":[{"code":"74220","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":189.76,"maximum":569.28,"gross_charge":593,"discounted_cash":343.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":563.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":569.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":432.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":492.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":432.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":284.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":205.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":189.76,"methodology":"fee schedule"}]}]},{"description":"SWALLOWING FUNCTION W VIDEO","code_information":[{"code":"74230","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":632.18,"maximum":831.36,"gross_charge":866,"discounted_cash":502.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":822.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":831.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":632.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":718.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":632.18,"methodology":"fee schedule"}]}]},{"description":"SWALLOWING FUNCTION W VIDEO","code_information":[{"code":"74230","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":277.12,"maximum":831.36,"gross_charge":866,"discounted_cash":502.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":822.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":831.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":632.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":718.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":632.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":415.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":300.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":277.12,"methodology":"fee schedule"}]}]},{"description":"UGI","code_information":[{"code":"74240","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":515.38,"maximum":677.76,"gross_charge":706,"discounted_cash":409.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":670.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":677.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":515.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":585.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":515.38,"methodology":"fee schedule"}]}]},{"description":"UGI","code_information":[{"code":"74240","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":225.92,"maximum":677.76,"gross_charge":706,"discounted_cash":409.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":670.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":677.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":515.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":585.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":515.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":338.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":244.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":225.92,"methodology":"fee schedule"}]}]},{"description":"UGI W AIR","code_information":[{"code":"74246","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":567.21,"maximum":745.92,"gross_charge":777,"discounted_cash":450.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":738.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":745.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":567.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":644.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":567.21,"methodology":"fee schedule"}]}]},{"description":"UGI W AIR","code_information":[{"code":"74246","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":248.64,"maximum":745.92,"gross_charge":777,"discounted_cash":450.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":738.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":745.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":567.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":644.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":567.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":372.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":269.47,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":248.64,"methodology":"fee schedule"}]}]},{"description":"SMALL BOWEL FOLLOW THRU","code_information":[{"code":"74248","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":515.38,"maximum":677.76,"gross_charge":706,"discounted_cash":409.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":670.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":677.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":515.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":585.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":515.38,"methodology":"fee schedule"}]}]},{"description":"SMALL BOWEL FOLLOW THRU","code_information":[{"code":"74248","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":225.92,"maximum":677.76,"gross_charge":706,"discounted_cash":409.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":670.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":677.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":515.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":585.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":515.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":338.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":244.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":225.92,"methodology":"fee schedule"}]}]},{"description":"SMALL BOWEL W SERIAL FILM","code_information":[{"code":"74250","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":519.03,"maximum":682.56,"gross_charge":711,"discounted_cash":412.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":675.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":682.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":519.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":590.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":519.03,"methodology":"fee schedule"}]}]},{"description":"SMALL BOWEL W SERIAL FILM","code_information":[{"code":"74250","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":227.52,"maximum":682.56,"gross_charge":711,"discounted_cash":412.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":675.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":682.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":519.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":590.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":519.03,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":341.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":246.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":227.52,"methodology":"fee schedule"}]}]},{"description":"BARIUM ENEMA COMP","code_information":[{"code":"74270","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":713.21,"maximum":937.92,"gross_charge":977,"discounted_cash":566.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":928.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":937.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":713.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":810.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":713.21,"methodology":"fee schedule"}]}]},{"description":"BARIUM ENEMA COMP","code_information":[{"code":"74270","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":312.64,"maximum":937.92,"gross_charge":977,"discounted_cash":566.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":928.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":937.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":713.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":810.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":713.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":468.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":338.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":312.64,"methodology":"fee schedule"}]}]},{"description":"BARIUM ENEMA W AIR","code_information":[{"code":"74280","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":1008.13,"maximum":1325.76,"gross_charge":1381,"discounted_cash":800.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1311.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1325.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1008.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1146.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1008.13,"methodology":"fee schedule"}]}]},{"description":"BARIUM ENEMA W AIR","code_information":[{"code":"74280","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":441.92,"maximum":1325.76,"gross_charge":1381,"discounted_cash":800.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1311.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1325.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1008.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1146.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1008.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":662.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":478.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":441.92,"methodology":"fee schedule"}]}]},{"description":"CHOLANGIOGRAM IN OR","code_information":[{"code":"74300","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":192.72,"maximum":253.44,"gross_charge":264,"discounted_cash":153.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":250.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":253.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":192.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":219.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":192.72,"methodology":"fee schedule"}]}]},{"description":"CHOLANGIOGRAM IN OR","code_information":[{"code":"74300","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":84.48,"maximum":253.44,"gross_charge":264,"discounted_cash":153.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":250.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":253.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":192.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":219.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":192.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":126.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":91.56,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":84.48,"methodology":"fee schedule"}]}]},{"description":"IVP W TOMOGRAMS","code_information":[{"code":"74400","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":588.38,"maximum":773.76,"gross_charge":806,"discounted_cash":467.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":765.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":773.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":588.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":668.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":588.38,"methodology":"fee schedule"}]}]},{"description":"IVP W TOMOGRAMS","code_information":[{"code":"74400","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":257.92,"maximum":773.76,"gross_charge":806,"discounted_cash":467.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":765.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":773.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":588.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":668.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":588.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":386.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":279.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":257.92,"methodology":"fee schedule"}]}]},{"description":"IVP WO TOMOGRAMS","code_information":[{"code":"74415","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":689.12,"maximum":906.24,"gross_charge":944,"discounted_cash":547.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":896.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":906.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":689.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":783.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":689.12,"methodology":"fee schedule"}]}]},{"description":"IVP WO TOMOGRAMS","code_information":[{"code":"74415","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":302.08,"maximum":906.24,"gross_charge":944,"discounted_cash":547.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":896.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":906.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":689.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":783.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":689.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":453.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":327.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":302.08,"methodology":"fee schedule"}]}]},{"description":"CYSTOGRAM VOIDING","code_information":[{"code":"74455","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":698.61,"maximum":918.72,"gross_charge":957,"discounted_cash":555.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":909.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":918.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":698.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":794.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":698.61,"methodology":"fee schedule"}]}]},{"description":"CYSTOGRAM VOIDING","code_information":[{"code":"74455","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":306.24,"maximum":918.72,"gross_charge":957,"discounted_cash":555.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":909.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":918.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":698.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":794.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":698.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":459.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":331.89,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":306.24,"methodology":"fee schedule"}]}]},{"description":"HSG","code_information":[{"code":"74740","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":357.7,"maximum":470.4,"gross_charge":490,"discounted_cash":284.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":465.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":470.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":357.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":406.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":357.7,"methodology":"fee schedule"}]}]},{"description":"HSG","code_information":[{"code":"74740","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":156.8,"maximum":470.4,"gross_charge":490,"discounted_cash":284.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":465.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":470.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":357.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":406.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":357.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":235.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":169.94,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":156.8,"methodology":"fee schedule"}]}]},{"description":"SCHIZOPHRENIA","code_information":[{"code":"7501","type":"APR-DRG"}],"standard_charges":[{"minimum":30203,"maximum":30203,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30203,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SCHIZOPHRENIA","code_information":[{"code":"7502","type":"APR-DRG"}],"standard_charges":[{"minimum":37849,"maximum":37849,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37849,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SCHIZOPHRENIA","code_information":[{"code":"7503","type":"APR-DRG"}],"standard_charges":[{"minimum":63355,"maximum":63355,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":63355,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"SCHIZOPHRENIA","code_information":[{"code":"7504","type":"APR-DRG"}],"standard_charges":[{"minimum":69690,"maximum":69690,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":69690,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES","code_information":[{"code":"7511","type":"APR-DRG"}],"standard_charges":[{"minimum":19714,"maximum":19714,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19714,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES","code_information":[{"code":"7512","type":"APR-DRG"}],"standard_charges":[{"minimum":22553,"maximum":22553,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22553,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES","code_information":[{"code":"7513","type":"APR-DRG"}],"standard_charges":[{"minimum":28640,"maximum":28640,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28640,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MAJOR DEPRESSIVE DISORDERS AND OTHER OR UNSPECIFIED PSYCHOSES","code_information":[{"code":"7514","type":"APR-DRG"}],"standard_charges":[{"minimum":71779,"maximum":71779,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":71779,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DISORDERS OF PERSONALITY AND IMPULSE CONTROL","code_information":[{"code":"7521","type":"APR-DRG"}],"standard_charges":[{"minimum":7544,"maximum":7544,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":7544,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DISORDERS OF PERSONALITY AND IMPULSE CONTROL","code_information":[{"code":"7522","type":"APR-DRG"}],"standard_charges":[{"minimum":20783,"maximum":20783,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20783,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DISORDERS OF PERSONALITY AND IMPULSE CONTROL","code_information":[{"code":"7523","type":"APR-DRG"}],"standard_charges":[{"minimum":22962,"maximum":22962,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22962,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DISORDERS OF PERSONALITY AND IMPULSE CONTROL","code_information":[{"code":"7524","type":"APR-DRG"}],"standard_charges":[{"minimum":96458,"maximum":96458,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":96458,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BIPOLAR DISORDERS","code_information":[{"code":"7531","type":"APR-DRG"}],"standard_charges":[{"minimum":19173,"maximum":19173,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19173,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BIPOLAR DISORDERS","code_information":[{"code":"7532","type":"APR-DRG"}],"standard_charges":[{"minimum":29058,"maximum":29058,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29058,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BIPOLAR DISORDERS","code_information":[{"code":"7533","type":"APR-DRG"}],"standard_charges":[{"minimum":39952,"maximum":39952,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":39952,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BIPOLAR DISORDERS","code_information":[{"code":"7534","type":"APR-DRG"}],"standard_charges":[{"minimum":44939,"maximum":44939,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44939,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER","code_information":[{"code":"7541","type":"APR-DRG"}],"standard_charges":[{"minimum":13414,"maximum":13414,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13414,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER","code_information":[{"code":"7542","type":"APR-DRG"}],"standard_charges":[{"minimum":18966,"maximum":18966,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18966,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER","code_information":[{"code":"7543","type":"APR-DRG"}],"standard_charges":[{"minimum":30093,"maximum":30093,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30093,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DEPRESSION EXCEPT MAJOR DEPRESSIVE DISORDER","code_information":[{"code":"7544","type":"APR-DRG"}],"standard_charges":[{"minimum":37556,"maximum":37556,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":37556,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES","code_information":[{"code":"7551","type":"APR-DRG"}],"standard_charges":[{"minimum":10848,"maximum":10848,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":10848,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES","code_information":[{"code":"7552","type":"APR-DRG"}],"standard_charges":[{"minimum":18349,"maximum":18349,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18349,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES","code_information":[{"code":"7553","type":"APR-DRG"}],"standard_charges":[{"minimum":25036,"maximum":25036,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25036,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ADJUSTMENT DISORDERS AND NEUROSES EXCEPT DEPRESSIVE DIAGNOSES","code_information":[{"code":"7554","type":"APR-DRG"}],"standard_charges":[{"minimum":30151,"maximum":30151,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30151,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE ANXIETY AND DELIRIUM STATES","code_information":[{"code":"7561","type":"APR-DRG"}],"standard_charges":[{"minimum":13255,"maximum":13255,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":13255,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE ANXIETY AND DELIRIUM STATES","code_information":[{"code":"7562","type":"APR-DRG"}],"standard_charges":[{"minimum":18905,"maximum":18905,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18905,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ACUTE ANXIETY AND DELIRIUM STATES","code_information":[{"code":"7563","type":"APR-DRG"}],"standard_charges":[{"minimum":19599,"maximum":19599,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":19599,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ANG ABDOMEN AORTA W RUNOFF BI","code_information":[{"code":"75635","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":3348.51,"maximum":4403.52,"gross_charge":4587,"discounted_cash":2660.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4357.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4403.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3348.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3807.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3348.51,"methodology":"fee schedule"}]}]},{"description":"ANG ABDOMEN AORTA W RUNOFF BI","code_information":[{"code":"75635","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1467.84,"maximum":4403.52,"gross_charge":4587,"discounted_cash":2660.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4357.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4403.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3348.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3807.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3348.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2201.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1590.78,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1467.84,"methodology":"fee schedule"}]}]},{"description":"ACUTE ANXIETY AND DELIRIUM STATES","code_information":[{"code":"7564","type":"APR-DRG"}],"standard_charges":[{"minimum":31725,"maximum":31725,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":31725,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ORGANIC MENTAL HEALTH DISTURBANCES","code_information":[{"code":"7571","type":"APR-DRG"}],"standard_charges":[{"minimum":20733,"maximum":20733,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20733,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ORGANIC MENTAL HEALTH DISTURBANCES","code_information":[{"code":"7572","type":"APR-DRG"}],"standard_charges":[{"minimum":30201,"maximum":30201,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":30201,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ORGANIC MENTAL HEALTH DISTURBANCES","code_information":[{"code":"7573","type":"APR-DRG"}],"standard_charges":[{"minimum":46119,"maximum":46119,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":46119,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ORGANIC MENTAL HEALTH DISTURBANCES","code_information":[{"code":"7574","type":"APR-DRG"}],"standard_charges":[{"minimum":55291,"maximum":55291,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":55291,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BEHAVIORAL DISORDERS","code_information":[{"code":"7581","type":"APR-DRG"}],"standard_charges":[{"minimum":12698,"maximum":12698,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12698,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BEHAVIORAL DISORDERS","code_information":[{"code":"7582","type":"APR-DRG"}],"standard_charges":[{"minimum":27997,"maximum":27997,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27997,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"VENOGRAM LOWER EXTREMITY BI","code_information":[{"code":"75822","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":621.23,"maximum":816.96,"gross_charge":851,"discounted_cash":493.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":808.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":816.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":621.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":706.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":621.23,"methodology":"fee schedule"}]}]},{"description":"VENOGRAM LOWER EXTREMITY BI","code_information":[{"code":"75822","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":272.32,"maximum":816.96,"gross_charge":851,"discounted_cash":493.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":808.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":816.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":621.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":706.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":621.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":408.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":295.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":272.32,"methodology":"fee schedule"}]}]},{"description":"BEHAVIORAL DISORDERS","code_information":[{"code":"7583","type":"APR-DRG"}],"standard_charges":[{"minimum":48824,"maximum":48824,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48824,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BEHAVIORAL DISORDERS","code_information":[{"code":"7584","type":"APR-DRG"}],"standard_charges":[{"minimum":64435,"maximum":64435,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":64435,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EATING DISORDERS","code_information":[{"code":"7591","type":"APR-DRG"}],"standard_charges":[{"minimum":14248,"maximum":14248,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14248,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EATING DISORDERS","code_information":[{"code":"7592","type":"APR-DRG"}],"standard_charges":[{"minimum":48004,"maximum":48004,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":48004,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EATING DISORDERS","code_information":[{"code":"7593","type":"APR-DRG"}],"standard_charges":[{"minimum":66707,"maximum":66707,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":66707,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EATING DISORDERS","code_information":[{"code":"7594","type":"APR-DRG"}],"standard_charges":[{"minimum":137640,"maximum":137640,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":137640,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FLUORO OVER 1HR W RAD","code_information":[{"code":"76000","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":292,"maximum":384,"gross_charge":400,"discounted_cash":232,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":380,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":384,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":292,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":332,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":292,"methodology":"fee schedule"}]}]},{"description":"FLUORO OVER 1HR W RAD","code_information":[{"code":"76000","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":128,"maximum":384,"gross_charge":400,"discounted_cash":232,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":380,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":384,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":292,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":332,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":292,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":192,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":138.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":128,"methodology":"fee schedule"}]}]},{"description":"OTHER MENTAL HEALTH DISORDERS","code_information":[{"code":"7601","type":"APR-DRG"}],"standard_charges":[{"minimum":23831,"maximum":23831,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":23831,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FB LOCALIZED NOSE RECTUM CHILD","code_information":[{"code":"76010","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":82.49,"maximum":108.48,"gross_charge":113,"discounted_cash":65.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":107.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":108.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":82.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":93.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":82.49,"methodology":"fee schedule"}]}]},{"description":"FB LOCALIZED NOSE RECTUM CHILD","code_information":[{"code":"76010","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":36.16,"maximum":108.48,"gross_charge":113,"discounted_cash":65.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":107.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":108.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":82.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":93.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":82.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":54.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":39.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":36.16,"methodology":"fee schedule"}]}]},{"description":"OTHER MENTAL HEALTH DISORDERS","code_information":[{"code":"7602","type":"APR-DRG"}],"standard_charges":[{"minimum":26216,"maximum":26216,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":26216,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MENTAL HEALTH DISORDERS","code_information":[{"code":"7603","type":"APR-DRG"}],"standard_charges":[{"minimum":28836,"maximum":28836,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":28836,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER MENTAL HEALTH DISORDERS","code_information":[{"code":"7604","type":"APR-DRG"}],"standard_charges":[{"minimum":42045,"maximum":42045,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":42045,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"FISTULA SINUS TRACT ABSCESS","code_information":[{"code":"76080","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":181.77,"maximum":239.04,"gross_charge":249,"discounted_cash":144.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":236.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":239.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":206.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":181.77,"methodology":"fee schedule"}]}]},{"description":"FISTULA SINUS TRACT ABSCESS","code_information":[{"code":"76080","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":79.68,"maximum":239.04,"gross_charge":249,"discounted_cash":144.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":236.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":239.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":206.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":119.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":86.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":79.68,"methodology":"fee schedule"}]}]},{"description":"SURGICAL SPECIMEN BREAST","code_information":[{"code":"76098","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":91.98,"maximum":120.96,"gross_charge":126,"discounted_cash":73.08,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":119.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":120.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":91.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":104.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":91.98,"methodology":"fee schedule"}]}]},{"description":"SURGICAL SPECIMEN BREAST","code_information":[{"code":"76098","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":40.32,"maximum":120.96,"gross_charge":126,"discounted_cash":73.08,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":119.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":120.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":91.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":104.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":91.98,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":60.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":43.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":40.32,"methodology":"fee schedule"}]}]},{"description":"LTD FOLLOW UP STUDY","code_information":[{"code":"76380","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":1095.73,"maximum":1440.96,"gross_charge":1501,"discounted_cash":870.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1425.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1440.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1095.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1245.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1095.73,"methodology":"fee schedule"}]}]},{"description":"LTD FOLLOW UP STUDY","code_information":[{"code":"76380","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":480.32,"maximum":1440.96,"gross_charge":1501,"discounted_cash":870.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1425.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1440.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1095.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1245.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1095.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":720.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":520.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":480.32,"methodology":"fee schedule"}]}]},{"description":"HEAD NECK SOFT TISSUE","code_information":[{"code":"76536","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":613.93,"maximum":807.36,"gross_charge":841,"discounted_cash":487.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":798.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":807.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":613.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":698.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":613.93,"methodology":"fee schedule"}]}]},{"description":"HEAD NECK SOFT TISSUE","code_information":[{"code":"76536","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":269.12,"maximum":807.36,"gross_charge":841,"discounted_cash":487.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":798.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":807.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":613.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":698.03,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":613.93,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":403.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":291.66,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":269.12,"methodology":"fee schedule"}]}]},{"description":"CHEST","code_information":[{"code":"76604","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":396.39,"maximum":521.28,"gross_charge":543,"discounted_cash":314.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":515.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":521.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":396.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":450.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":396.39,"methodology":"fee schedule"}]}]},{"description":"CHEST","code_information":[{"code":"76604","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":173.76,"maximum":521.28,"gross_charge":543,"discounted_cash":314.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":515.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":521.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":396.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":450.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":396.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":260.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":188.32,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":173.76,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN COMP","code_information":[{"code":"76700","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":665.76,"maximum":875.52,"gross_charge":912,"discounted_cash":528.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":866.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":875.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":665.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":756.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":665.76,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN COMP","code_information":[{"code":"76700","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":291.84,"maximum":875.52,"gross_charge":912,"discounted_cash":528.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":866.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":875.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":665.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":756.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":665.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":437.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":316.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":291.84,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN LTD","code_information":[{"code":"76705","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":475.23,"maximum":624.96,"gross_charge":651,"discounted_cash":377.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":618.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":624.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":475.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":540.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":475.23,"methodology":"fee schedule"}]}]},{"description":"ABDOMEN LTD","code_information":[{"code":"76705","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":208.32,"maximum":624.96,"gross_charge":651,"discounted_cash":377.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":618.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":624.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":475.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":540.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":475.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":312.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":225.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":208.32,"methodology":"fee schedule"}]}]},{"description":"AAA SCREEN","code_information":[{"code":"76706","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":427.78,"maximum":562.56,"gross_charge":586,"discounted_cash":339.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":556.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":562.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":427.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":486.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":427.78,"methodology":"fee schedule"}]}]},{"description":"AAA SCREEN","code_information":[{"code":"76706","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":187.52,"maximum":562.56,"gross_charge":586,"discounted_cash":339.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":556.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":562.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":427.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":486.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":427.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":281.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":203.23,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":187.52,"methodology":"fee schedule"}]}]},{"description":"RENAL COMP","code_information":[{"code":"76770","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":486.91,"maximum":640.32,"gross_charge":667,"discounted_cash":386.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":633.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":640.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":486.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":553.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":486.91,"methodology":"fee schedule"}]}]},{"description":"RENAL COMP","code_information":[{"code":"76770","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":213.44,"maximum":640.32,"gross_charge":667,"discounted_cash":386.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":633.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":640.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":486.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":553.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":486.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":320.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":231.32,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":213.44,"methodology":"fee schedule"}]}]},{"description":"AORTA LTD DUPLEX","code_information":[{"code":"76775","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":423.4,"maximum":556.8,"gross_charge":580,"discounted_cash":336.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":551,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":556.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":423.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":481.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":423.4,"methodology":"fee schedule"}]}]},{"description":"AORTA LTD DUPLEX","code_information":[{"code":"76775","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":185.6,"maximum":556.8,"gross_charge":580,"discounted_cash":336.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":551,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":556.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":423.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":481.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":423.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":278.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":201.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":185.6,"methodology":"fee schedule"}]}]},{"description":"OB 1ST TRI SGL 1ST GEST","code_information":[{"code":"76801","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":450.41,"maximum":592.32,"gross_charge":617,"discounted_cash":357.86,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":586.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":592.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":450.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":512.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":450.41,"methodology":"fee schedule"}]}]},{"description":"OB 1ST TRI SGL 1ST GEST","code_information":[{"code":"76801","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":197.44,"maximum":592.32,"gross_charge":617,"discounted_cash":357.86,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":586.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":592.32,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":450.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":512.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":450.41,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":296.16,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":213.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":197.44,"methodology":"fee schedule"}]}]},{"description":"OB 1ST TRI EA ADDL GEST","code_information":[{"code":"76802","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":252.58,"maximum":332.16,"gross_charge":346,"discounted_cash":200.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":328.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":332.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":252.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":287.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":252.58,"methodology":"fee schedule"}]}]},{"description":"OB 1ST TRI EA ADDL GEST","code_information":[{"code":"76802","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":110.72,"maximum":332.16,"gross_charge":346,"discounted_cash":200.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":328.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":332.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":252.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":287.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":252.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":166.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":120,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":110.72,"methodology":"fee schedule"}]}]},{"description":"OB 2 OR 3 TRI SGL 1ST GEST","code_information":[{"code":"76805","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":563.56,"maximum":741.12,"gross_charge":772,"discounted_cash":447.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":733.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":741.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":563.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":640.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":563.56,"methodology":"fee schedule"}]}]},{"description":"OB 2 OR 3 TRI SGL 1ST GEST","code_information":[{"code":"76805","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":247.04,"maximum":741.12,"gross_charge":772,"discounted_cash":447.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":733.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":741.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":563.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":640.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":563.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":370.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":267.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":247.04,"methodology":"fee schedule"}]}]},{"description":"OB 2 OR 3 TRI EA ADDL GEST","code_information":[{"code":"76810","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":536.55,"maximum":705.6,"gross_charge":735,"discounted_cash":426.3,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":698.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":705.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":536.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":610.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":536.55,"methodology":"fee schedule"}]}]},{"description":"OB 2 OR 3 TRI EA ADDL GEST","code_information":[{"code":"76810","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":235.2,"maximum":705.6,"gross_charge":735,"discounted_cash":426.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":698.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":705.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":536.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":610.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":536.55,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":352.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":254.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":235.2,"methodology":"fee schedule"}]}]},{"description":"OB LTD 1 OR MORE FETUS","code_information":[{"code":"76815","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":434.35,"maximum":571.2,"gross_charge":595,"discounted_cash":345.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":565.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":571.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":434.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":493.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":434.35,"methodology":"fee schedule"}]}]},{"description":"OB LTD 1 OR MORE FETUS","code_information":[{"code":"76815","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":190.4,"maximum":571.2,"gross_charge":595,"discounted_cash":345.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":565.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":571.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":434.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":493.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":434.35,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":285.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":206.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":190.4,"methodology":"fee schedule"}]}]},{"description":"OB FOLLOW UP 1ST GEST","code_information":[{"code":"76816","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":443.11,"maximum":582.72,"gross_charge":607,"discounted_cash":352.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":576.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":582.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":443.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":503.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":443.11,"methodology":"fee schedule"}]}]},{"description":"OB FOLLOW UP 1ST GEST","code_information":[{"code":"76816","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":194.24,"maximum":582.72,"gross_charge":607,"discounted_cash":352.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":576.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":582.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":443.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":503.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":443.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":291.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":210.51,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":194.24,"methodology":"fee schedule"}]}]},{"description":"OB TRANSVAGINAL","code_information":[{"code":"76817","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":364.27,"maximum":479.04,"gross_charge":499,"discounted_cash":289.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":474.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":479.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":364.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":414.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":364.27,"methodology":"fee schedule"}]}]},{"description":"OB TRANSVAGINAL","code_information":[{"code":"76817","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":159.68,"maximum":479.04,"gross_charge":499,"discounted_cash":289.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":474.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":479.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":364.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":414.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":364.27,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":239.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":173.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":159.68,"methodology":"fee schedule"}]}]},{"description":"FETAL BPP W NST","code_information":[{"code":"76818","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":424.13,"maximum":557.76,"gross_charge":581,"discounted_cash":336.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":551.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":557.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":424.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":482.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":424.13,"methodology":"fee schedule"}]}]},{"description":"FETAL BPP W NST","code_information":[{"code":"76818","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":185.92,"maximum":557.76,"gross_charge":581,"discounted_cash":336.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":551.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":557.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":424.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":482.23,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":424.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":278.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":201.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":185.92,"methodology":"fee schedule"}]}]},{"description":"FETAL BPP WO NST","code_information":[{"code":"76819","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":346.75,"maximum":456,"gross_charge":475,"discounted_cash":275.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":451.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":456,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":346.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":394.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":346.75,"methodology":"fee schedule"}]}]},{"description":"FETAL BPP WO NST","code_information":[{"code":"76819","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":152,"maximum":456,"gross_charge":475,"discounted_cash":275.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":451.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":456,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":346.75,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":394.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":346.75,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":228,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":164.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":152,"methodology":"fee schedule"}]}]},{"description":"FETAL DOPPLER UMBILICAL","code_information":[{"code":"76820","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":141.62,"maximum":186.24,"gross_charge":194,"discounted_cash":112.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":184.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":186.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":141.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":161.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":141.62,"methodology":"fee schedule"}]}]},{"description":"FETAL DOPPLER UMBILICAL","code_information":[{"code":"76820","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":62.08,"maximum":186.24,"gross_charge":194,"discounted_cash":112.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":184.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":186.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":141.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":161.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":141.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":67.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":62.08,"methodology":"fee schedule"}]}]},{"description":"TRANSVAGINAL NON OB","code_information":[{"code":"76830","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":568.67,"maximum":747.84,"gross_charge":779,"discounted_cash":451.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":740.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":747.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":568.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":646.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":568.67,"methodology":"fee schedule"}]}]},{"description":"TRANSVAGINAL NON OB","code_information":[{"code":"76830","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":249.28,"maximum":747.84,"gross_charge":779,"discounted_cash":451.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":740.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":747.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":568.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":646.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":568.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":373.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":270.16,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":249.28,"methodology":"fee schedule"}]}]},{"description":"PELVIS NON OB COMP","code_information":[{"code":"76856","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":492.02,"maximum":647.04,"gross_charge":674,"discounted_cash":390.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":640.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":647.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":492.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":559.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":492.02,"methodology":"fee schedule"}]}]},{"description":"PELVIS NON OB COMP","code_information":[{"code":"76856","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":215.68,"maximum":647.04,"gross_charge":674,"discounted_cash":390.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":640.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":647.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":492.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":559.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":492.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":323.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":233.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":215.68,"methodology":"fee schedule"}]}]},{"description":"PELVIS NON OB LTD","code_information":[{"code":"76857","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":398.58,"maximum":524.16,"gross_charge":546,"discounted_cash":316.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":518.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":524.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":398.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":453.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":398.58,"methodology":"fee schedule"}]}]},{"description":"PELVIS NON OB LTD","code_information":[{"code":"76857","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":174.72,"maximum":524.16,"gross_charge":546,"discounted_cash":316.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":518.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":524.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":398.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":453.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":398.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":262.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":189.36,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":174.72,"methodology":"fee schedule"}]}]},{"description":"SCROTUM AND CONTENTS","code_information":[{"code":"76870","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":479.61,"maximum":630.72,"gross_charge":657,"discounted_cash":381.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":624.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":630.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":479.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":545.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":479.61,"methodology":"fee schedule"}]}]},{"description":"SCROTUM AND CONTENTS","code_information":[{"code":"76870","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":210.24,"maximum":630.72,"gross_charge":657,"discounted_cash":381.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":624.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":630.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":479.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":545.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":479.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":315.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":227.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":210.24,"methodology":"fee schedule"}]}]},{"description":"HIPS INFANT COMP DYNAMIC","code_information":[{"code":"76885","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":668.68,"maximum":879.36,"gross_charge":916,"discounted_cash":531.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":870.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":879.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":668.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":760.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":668.68,"methodology":"fee schedule"}]}]},{"description":"HIPS INFANT COMP DYNAMIC","code_information":[{"code":"76885","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":293.12,"maximum":879.36,"gross_charge":916,"discounted_cash":531.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":870.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":879.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":668.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":760.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":668.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":439.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":317.67,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":293.12,"methodology":"fee schedule"}]}]},{"description":"GUIDE NEEDLE BIOPSY","code_information":[{"code":"76942","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":581.81,"maximum":765.12,"gross_charge":797,"discounted_cash":462.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":757.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":765.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":581.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":661.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":581.81,"methodology":"fee schedule"}]}]},{"description":"GUIDE NEEDLE BIOPSY","code_information":[{"code":"76942","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":255.04,"maximum":765.12,"gross_charge":797,"discounted_cash":462.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":757.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":765.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":581.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":661.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":581.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":382.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":276.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":255.04,"methodology":"fee schedule"}]}]},{"description":"GUIDE AMIOCENTESIS","code_information":[{"code":"76946","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":405.88,"maximum":533.76,"gross_charge":556,"discounted_cash":322.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":528.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":533.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":405.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":461.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":405.88,"methodology":"fee schedule"}]}]},{"description":"GUIDE AMIOCENTESIS","code_information":[{"code":"76946","type":"CPT"},{"code":"0402","type":"RC"}],"standard_charges":[{"minimum":177.92,"maximum":533.76,"gross_charge":556,"discounted_cash":322.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":528.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":533.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":405.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":461.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":405.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":266.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":192.83,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":177.92,"methodology":"fee schedule"}]}]},{"description":"DRAIN ABSCESS OR CYST","code_information":[{"code":"77002","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":365.73,"maximum":480.96,"gross_charge":501,"discounted_cash":290.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":475.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":480.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":365.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":415.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":365.73,"methodology":"fee schedule"}]}]},{"description":"DRAIN ABSCESS OR CYST","code_information":[{"code":"77002","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":160.32,"maximum":480.96,"gross_charge":501,"discounted_cash":290.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":475.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":480.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":365.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":415.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":365.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":240.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":173.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":160.32,"methodology":"fee schedule"}]}]},{"description":"DRAIN HEMOTOMA SEROMA","code_information":[{"code":"77002","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":365.73,"maximum":480.96,"gross_charge":501,"discounted_cash":290.58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":475.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":480.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":365.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":415.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":365.73,"methodology":"fee schedule"}]}]},{"description":"DRAIN HEMOTOMA SEROMA","code_information":[{"code":"77002","type":"CPT"},{"code":"0361","type":"RC"}],"standard_charges":[{"minimum":160.32,"maximum":480.96,"gross_charge":501,"discounted_cash":290.58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":475.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":480.96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":365.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":415.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":365.73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":240.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":173.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":160.32,"methodology":"fee schedule"}]}]},{"description":"DRUG AND ALCOHOL ABUSE OR DEPENDENCE LEFT AGAINST MEDICAL ADVICE","code_information":[{"code":"7701","type":"APR-DRG"}],"standard_charges":[{"minimum":7676,"maximum":7676,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":7676,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"GUIDE","code_information":[{"code":"77012","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":766.5,"maximum":1008,"gross_charge":1050,"discounted_cash":609,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":997.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1008,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":766.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":871.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":766.5,"methodology":"fee schedule"}]}]},{"description":"GUIDE","code_information":[{"code":"77012","type":"CPT"},{"code":"0352","type":"RC"}],"standard_charges":[{"minimum":336,"maximum":1008,"gross_charge":1050,"discounted_cash":609,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":997.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1008,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":766.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":871.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":766.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":504,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":364.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":336,"methodology":"fee schedule"}]}]},{"description":"DRUG AND ALCOHOL ABUSE OR DEPENDENCE LEFT AGAINST MEDICAL ADVICE","code_information":[{"code":"7702","type":"APR-DRG"}],"standard_charges":[{"minimum":8433,"maximum":8433,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":8433,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DRUG AND ALCOHOL ABUSE OR DEPENDENCE LEFT AGAINST MEDICAL ADVICE","code_information":[{"code":"7703","type":"APR-DRG"}],"standard_charges":[{"minimum":14666,"maximum":14666,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":14666,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DRUG AND ALCOHOL ABUSE OR DEPENDENCE LEFT AGAINST MEDICAL ADVICE","code_information":[{"code":"7704","type":"APR-DRG"}],"standard_charges":[{"minimum":29258,"maximum":29258,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":29258,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"DIAGNOSTIC TOMO BI","code_information":[{"code":"77062","type":"CPT"},{"code":"0401","type":"RC"}],"standard_charges":[{"minimum":243.09,"maximum":319.68,"gross_charge":333,"discounted_cash":193.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":316.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":319.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":276.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.09,"methodology":"fee schedule"}]}]},{"description":"DIAGNOSTIC TOMO BI","code_information":[{"code":"77062","type":"CPT"},{"code":"0401","type":"RC"}],"standard_charges":[{"minimum":106.56,"maximum":319.68,"gross_charge":333,"discounted_cash":193.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":316.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":319.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":243.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":276.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":243.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":159.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":115.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":106.56,"methodology":"fee schedule"}]}]},{"description":"SCREENING TOMO BI","code_information":[{"code":"77063","type":"CPT"},{"code":"0403","type":"RC"}],"standard_charges":[{"minimum":241.63,"maximum":317.76,"gross_charge":331,"discounted_cash":191.98,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":314.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":317.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":241.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":274.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":241.63,"methodology":"fee schedule"}]}]},{"description":"SCREENING TOMO BI","code_information":[{"code":"77063","type":"CPT"},{"code":"0403","type":"RC"}],"standard_charges":[{"minimum":51.33,"maximum":317.76,"gross_charge":331,"discounted_cash":191.98,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":314.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":317.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":241.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":274.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":241.63,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":158.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":51.33,"standard_charge_algorithm": "Lesser of $51.33 or 81.6 Percent of Billed Charges","median_amount":114.79,"10th_percentile":101.83,"90th_percentile":114.79,"count":"35","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":51.45,"standard_charge_algorithm": "Lesser of $51.45 or 80 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"DIAGNOSTIC DIGITAL BI","code_information":[{"code":"77066","type":"CPT"},{"code":"0401","type":"RC"}],"standard_charges":[{"minimum":659.19,"maximum":866.88,"gross_charge":903,"discounted_cash":523.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":857.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":866.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":659.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":749.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":659.19,"methodology":"fee schedule"}]}]},{"description":"DIAGNOSTIC DIGITAL BI","code_information":[{"code":"77066","type":"CPT"},{"code":"0401","type":"RC"}],"standard_charges":[{"minimum":288.96,"maximum":866.88,"gross_charge":903,"discounted_cash":523.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":857.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":866.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":659.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":749.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":659.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":433.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":313.17,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":288.96,"methodology":"fee schedule"}]}]},{"description":"SCREENING DIGITAL BI","code_information":[{"code":"77067","type":"CPT"},{"code":"0403","type":"RC"}],"standard_charges":[{"minimum":576.7,"maximum":758.4,"gross_charge":790,"discounted_cash":458.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":750.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":758.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":576.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":655.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":576.7,"methodology":"fee schedule"}]}]},{"description":"SCREENING DIGITAL BI","code_information":[{"code":"77067","type":"CPT"},{"code":"0403","type":"RC"}],"standard_charges":[{"minimum":91.23,"maximum":758.4,"gross_charge":790,"discounted_cash":458.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":750.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":758.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":576.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":655.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":576.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":379.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":91.23,"standard_charge_algorithm": "Lesser of $91.23 or 81.6 Percent of Billed Charges","median_amount":273.97,"10th_percentile":243.17,"90th_percentile":273.97,"count":"35","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":92.05,"standard_charge_algorithm": "Lesser of $92.05 or 80 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"BONE SURVEY COMP METS","code_information":[{"code":"77075","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":567.94,"maximum":746.88,"gross_charge":778,"discounted_cash":451.24,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":739.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":746.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":567.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":645.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":567.94,"methodology":"fee schedule"}]}]},{"description":"BONE SURVEY COMP METS","code_information":[{"code":"77075","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":248.96,"maximum":746.88,"gross_charge":778,"discounted_cash":451.24,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":739.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":746.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":567.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":645.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":567.94,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":373.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":269.82,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":248.96,"methodology":"fee schedule"}]}]},{"description":"DEXA BONE DENSITY BODY","code_information":[{"code":"77080","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":593.49,"maximum":780.48,"gross_charge":813,"discounted_cash":471.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":772.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":780.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":593.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":674.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":593.49,"methodology":"fee schedule"}]}]},{"description":"DEXA BONE DENSITY BODY","code_information":[{"code":"77080","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":260.16,"maximum":780.48,"gross_charge":813,"discounted_cash":471.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":772.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":780.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":593.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":674.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":593.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":390.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":281.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":260.16,"methodology":"fee schedule"}]}]},{"description":"DEXA BONE DENSITY PERIPHERAL","code_information":[{"code":"77081","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":136.51,"maximum":179.52,"gross_charge":187,"discounted_cash":108.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":177.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":179.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":136.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":155.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":136.51,"methodology":"fee schedule"}]}]},{"description":"DEXA BONE DENSITY PERIPHERAL","code_information":[{"code":"77081","type":"CPT"},{"code":"0320","type":"RC"}],"standard_charges":[{"minimum":59.84,"maximum":179.52,"gross_charge":187,"discounted_cash":108.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":177.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":179.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":136.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":155.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":136.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":89.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":64.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":59.84,"methodology":"fee schedule"}]}]},{"description":"ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY","code_information":[{"code":"7721","type":"APR-DRG"}],"standard_charges":[{"minimum":15648,"maximum":15648,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15648,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY","code_information":[{"code":"7722","type":"APR-DRG"}],"standard_charges":[{"minimum":22273,"maximum":22273,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22273,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY","code_information":[{"code":"7723","type":"APR-DRG"}],"standard_charges":[{"minimum":27275,"maximum":27275,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":27275,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY","code_information":[{"code":"7724","type":"APR-DRG"}],"standard_charges":[{"minimum":47289,"maximum":47289,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":47289,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPIOID ABUSE AND DEPENDENCE","code_information":[{"code":"7731","type":"APR-DRG"}],"standard_charges":[{"minimum":11355,"maximum":11355,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11355,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPIOID ABUSE AND DEPENDENCE","code_information":[{"code":"7732","type":"APR-DRG"}],"standard_charges":[{"minimum":15455,"maximum":15455,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15455,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPIOID ABUSE AND DEPENDENCE","code_information":[{"code":"7733","type":"APR-DRG"}],"standard_charges":[{"minimum":17138,"maximum":17138,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17138,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OPIOID ABUSE AND DEPENDENCE","code_information":[{"code":"7734","type":"APR-DRG"}],"standard_charges":[{"minimum":40534,"maximum":40534,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":40534,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COCAINE ABUSE AND DEPENDENCE","code_information":[{"code":"7741","type":"APR-DRG"}],"standard_charges":[{"minimum":7935,"maximum":7935,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":7935,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COCAINE ABUSE AND DEPENDENCE","code_information":[{"code":"7742","type":"APR-DRG"}],"standard_charges":[{"minimum":12574,"maximum":12574,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12574,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COCAINE ABUSE AND DEPENDENCE","code_information":[{"code":"7743","type":"APR-DRG"}],"standard_charges":[{"minimum":17868,"maximum":17868,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":17868,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"COCAINE ABUSE AND DEPENDENCE","code_information":[{"code":"7744","type":"APR-DRG"}],"standard_charges":[{"minimum":43154,"maximum":43154,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":43154,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALCOHOL ABUSE AND DEPENDENCE","code_information":[{"code":"7751","type":"APR-DRG"}],"standard_charges":[{"minimum":11398,"maximum":11398,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":11398,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALCOHOL ABUSE AND DEPENDENCE","code_information":[{"code":"7752","type":"APR-DRG"}],"standard_charges":[{"minimum":12770,"maximum":12770,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":12770,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALCOHOL ABUSE AND DEPENDENCE","code_information":[{"code":"7753","type":"APR-DRG"}],"standard_charges":[{"minimum":20729,"maximum":20729,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20729,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"ALCOHOL ABUSE AND DEPENDENCE","code_information":[{"code":"7754","type":"APR-DRG"}],"standard_charges":[{"minimum":22803,"maximum":22803,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22803,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DRUG ABUSE AND DEPENDENCE","code_information":[{"code":"7761","type":"APR-DRG"}],"standard_charges":[{"minimum":18929,"maximum":18929,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":18929,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DRUG ABUSE AND DEPENDENCE","code_information":[{"code":"7762","type":"APR-DRG"}],"standard_charges":[{"minimum":20744,"maximum":20744,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":20744,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DRUG ABUSE AND DEPENDENCE","code_information":[{"code":"7763","type":"APR-DRG"}],"standard_charges":[{"minimum":36275,"maximum":36275,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":36275,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"OTHER DRUG ABUSE AND DEPENDENCE","code_information":[{"code":"7764","type":"APR-DRG"}],"standard_charges":[{"minimum":39902,"maximum":39902,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":39902,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"PARATHYROID IMAGING","code_information":[{"code":"78070","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1681.92,"maximum":2211.84,"gross_charge":2304,"discounted_cash":1336.32,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2188.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2211.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1681.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1912.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1681.92,"methodology":"fee schedule"}]}]},{"description":"PARATHYROID IMAGING","code_information":[{"code":"78070","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":737.28,"maximum":2211.84,"gross_charge":2304,"discounted_cash":1336.32,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2188.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2211.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1681.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1912.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1681.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1105.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":799.03,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":737.28,"methodology":"fee schedule"}]}]},{"description":"LIVER IMAGING STATIC","code_information":[{"code":"78201","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1081.86,"maximum":1422.72,"gross_charge":1482,"discounted_cash":859.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1407.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1422.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1081.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1230.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1081.86,"methodology":"fee schedule"}]}]},{"description":"LIVER IMAGING STATIC","code_information":[{"code":"78201","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":474.24,"maximum":1422.72,"gross_charge":1482,"discounted_cash":859.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1407.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1422.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1081.86,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1230.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1081.86,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":711.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":513.96,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":474.24,"methodology":"fee schedule"}]}]},{"description":"LIVER SPLEEN IMAGING","code_information":[{"code":"78215","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1095,"maximum":1440,"gross_charge":1500,"discounted_cash":870,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1425,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1440,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1095,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1245,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1095,"methodology":"fee schedule"}]}]},{"description":"LIVER SPLEEN IMAGING","code_information":[{"code":"78215","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":480,"maximum":1440,"gross_charge":1500,"discounted_cash":870,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1425,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1440,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1095,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1245,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1095,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":720,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":520.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":480,"methodology":"fee schedule"}]}]},{"description":"CHOLESCINTIGRAPHY","code_information":[{"code":"78226","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1863.69,"maximum":2450.88,"gross_charge":2553,"discounted_cash":1480.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2425.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2450.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1863.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2118.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1863.69,"methodology":"fee schedule"}]}]},{"description":"CHOLESCINTIGRAPHY","code_information":[{"code":"78226","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":816.96,"maximum":2450.88,"gross_charge":2553,"discounted_cash":1480.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2425.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2450.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1863.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2118.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1863.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1225.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":885.39,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":816.96,"methodology":"fee schedule"}]}]},{"description":"CHOLESCINTIGRAPHY W PHARM INT","code_information":[{"code":"78227","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":2167.37,"maximum":2850.24,"gross_charge":2969,"discounted_cash":1722.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2820.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2850.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2167.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2464.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2167.37,"methodology":"fee schedule"}]}]},{"description":"CHOLESCINTIGRAPHY W PHARM INT","code_information":[{"code":"78227","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":950.08,"maximum":2850.24,"gross_charge":2969,"discounted_cash":1722.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2820.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2850.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2167.37,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2464.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2167.37,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1425.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1029.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":950.08,"methodology":"fee schedule"}]}]},{"description":"GASTRIC EMPTY STUDY","code_information":[{"code":"78264","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1911.87,"maximum":2514.24,"gross_charge":2619,"discounted_cash":1519.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2488.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2514.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1911.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2173.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1911.87,"methodology":"fee schedule"}]}]},{"description":"GASTRIC EMPTY STUDY","code_information":[{"code":"78264","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":838.08,"maximum":2514.24,"gross_charge":2619,"discounted_cash":1519.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2488.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2514.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1911.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2173.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1911.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1257.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":908.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":838.08,"methodology":"fee schedule"}]}]},{"description":"GI BLOOD LOSS","code_information":[{"code":"78278","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1931.58,"maximum":2540.16,"gross_charge":2646,"discounted_cash":1534.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2513.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2540.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1931.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2196.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1931.58,"methodology":"fee schedule"}]}]},{"description":"GI BLOOD LOSS","code_information":[{"code":"78278","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":846.72,"maximum":2540.16,"gross_charge":2646,"discounted_cash":1534.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2513.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2540.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1931.58,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2196.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1931.58,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1270.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":917.64,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":846.72,"methodology":"fee schedule"}]}]},{"description":"BOWEL IMAGING MECKELS","code_information":[{"code":"78290","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1914.06,"maximum":2517.12,"gross_charge":2622,"discounted_cash":1520.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2490.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2517.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1914.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2176.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1914.06,"methodology":"fee schedule"}]}]},{"description":"BOWEL IMAGING MECKELS","code_information":[{"code":"78290","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":839.04,"maximum":2517.12,"gross_charge":2622,"discounted_cash":1520.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2490.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2517.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1914.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2176.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1914.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1258.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":909.31,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":839.04,"methodology":"fee schedule"}]}]},{"description":"BONE SCAN LIMITED","code_information":[{"code":"78300","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1368.02,"maximum":1799.04,"gross_charge":1874,"discounted_cash":1086.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1780.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1799.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1368.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1555.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1368.02,"methodology":"fee schedule"}]}]},{"description":"BONE SCAN LIMITED","code_information":[{"code":"78300","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":599.68,"maximum":1799.04,"gross_charge":1874,"discounted_cash":1086.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1780.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1799.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1368.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1555.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1368.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":899.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":649.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":599.68,"methodology":"fee schedule"}]}]},{"description":"BONE SCAN MULTI AREA","code_information":[{"code":"78305","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1655.64,"maximum":2177.28,"gross_charge":2268,"discounted_cash":1315.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2154.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2177.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1655.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1882.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1655.64,"methodology":"fee schedule"}]}]},{"description":"BONE SCAN MULTI AREA","code_information":[{"code":"78305","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":725.76,"maximum":2177.28,"gross_charge":2268,"discounted_cash":1315.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2154.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2177.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1655.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1882.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1655.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1088.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":786.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":725.76,"methodology":"fee schedule"}]}]},{"description":"BONE SCAN WHOLE BODY","code_information":[{"code":"78306","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1800.18,"maximum":2367.36,"gross_charge":2466,"discounted_cash":1430.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2342.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2367.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1800.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2046.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1800.18,"methodology":"fee schedule"}]}]},{"description":"BONE SCAN WHOLE BODY","code_information":[{"code":"78306","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":789.12,"maximum":2367.36,"gross_charge":2466,"discounted_cash":1430.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2342.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2367.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1800.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2046.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1800.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1183.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":855.21,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":789.12,"methodology":"fee schedule"}]}]},{"description":"BONE SCAN 3 PHASE","code_information":[{"code":"78315","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":2033.78,"maximum":2674.56,"gross_charge":2786,"discounted_cash":1615.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2646.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2674.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2033.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2312.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2033.78,"methodology":"fee schedule"}]}]},{"description":"BONE SCAN 3 PHASE","code_information":[{"code":"78315","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":891.52,"maximum":2674.56,"gross_charge":2786,"discounted_cash":1615.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2646.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2674.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2033.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2312.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2033.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1337.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":966.19,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":891.52,"methodology":"fee schedule"}]}]},{"description":"MYOCARDIAL PERF SPECT SINGL","code_information":[{"code":"78451","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":2485.65,"maximum":3268.8,"gross_charge":3405,"discounted_cash":1974.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3234.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3268.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2485.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2826.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2485.65,"methodology":"fee schedule"}]}]},{"description":"MYOCARDIAL PERF SPECT SINGL","code_information":[{"code":"78451","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1089.6,"maximum":3268.8,"gross_charge":3405,"discounted_cash":1974.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":3234.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":3268.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":2485.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2826.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":2485.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1634.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1180.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1089.6,"methodology":"fee schedule"}]}]},{"description":"MYOCARDIAL PERF SPECT MULTI","code_information":[{"code":"78452","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":3404.72,"maximum":4477.44,"gross_charge":4664,"discounted_cash":2705.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4430.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4477.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3404.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3871.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3404.72,"methodology":"fee schedule"}]}]},{"description":"MYOCARDIAL PERF SPECT MULTI","code_information":[{"code":"78452","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1492.48,"maximum":4477.44,"gross_charge":4664,"discounted_cash":2705.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":4430.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":4477.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":3404.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":3871.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":3404.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":2238.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":1617.48,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":1492.48,"methodology":"fee schedule"}]}]},{"description":"MUGA RESTING","code_information":[{"code":"78472","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1199.39,"maximum":1577.28,"gross_charge":1643,"discounted_cash":952.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1560.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1577.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1199.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1363.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1199.39,"methodology":"fee schedule"}]}]},{"description":"MUGA RESTING","code_information":[{"code":"78472","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":525.76,"maximum":1577.28,"gross_charge":1643,"discounted_cash":952.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1560.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1577.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1199.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1363.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1199.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":788.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":569.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":525.76,"methodology":"fee schedule"}]}]},{"description":"PULMONARY PERFUSION IMAGING","code_information":[{"code":"78580","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1302.32,"maximum":1712.64,"gross_charge":1784,"discounted_cash":1034.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1694.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1712.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1302.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1480.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1302.32,"methodology":"fee schedule"}]}]},{"description":"PULMONARY PERFUSION IMAGING","code_information":[{"code":"78580","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":570.88,"maximum":1712.64,"gross_charge":1784,"discounted_cash":1034.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1694.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1712.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1302.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1480.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1302.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":856.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":618.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":570.88,"methodology":"fee schedule"}]}]},{"description":"LUNG VENT PERFUSION","code_information":[{"code":"78582","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1813.32,"maximum":2384.64,"gross_charge":2484,"discounted_cash":1440.72,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2359.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2384.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1813.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2061.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1813.32,"methodology":"fee schedule"}]}]},{"description":"LUNG VENT PERFUSION","code_information":[{"code":"78582","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":794.88,"maximum":2384.64,"gross_charge":2484,"discounted_cash":1440.72,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":2359.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":2384.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1813.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":2061.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1813.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":1192.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":861.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":794.88,"methodology":"fee schedule"}]}]},{"description":"KIDNEY IMG FUNCTION","code_information":[{"code":"78707","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1200.85,"maximum":1579.2,"gross_charge":1645,"discounted_cash":954.1,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1562.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1579.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1365.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1200.85,"methodology":"fee schedule"}]}]},{"description":"KIDNEY IMG FUNCTION","code_information":[{"code":"78707","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":526.4,"maximum":1579.2,"gross_charge":1645,"discounted_cash":954.1,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1562.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1579.2,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1200.85,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1365.35,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1200.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":789.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":570.49,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":526.4,"methodology":"fee schedule"}]}]},{"description":"KIDNEY IMG CAPTOPRIL","code_information":[{"code":"78708","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":841.69,"maximum":1106.88,"gross_charge":1153,"discounted_cash":668.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1095.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1106.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":841.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":956.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":841.69,"methodology":"fee schedule"}]}]},{"description":"KIDNEY IMG CAPTOPRIL","code_information":[{"code":"78708","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":368.96,"maximum":1106.88,"gross_charge":1153,"discounted_cash":668.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1095.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1106.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":841.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":956.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":841.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":553.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":399.87,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":368.96,"methodology":"fee schedule"}]}]},{"description":"URETERAL REFLUX STUDY","code_information":[{"code":"78740","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1225.67,"maximum":1611.84,"gross_charge":1679,"discounted_cash":973.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1595.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1611.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1225.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1393.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1225.67,"methodology":"fee schedule"}]}]},{"description":"URETERAL REFLUX STUDY","code_information":[{"code":"78740","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":537.28,"maximum":1611.84,"gross_charge":1679,"discounted_cash":973.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1595.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1611.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1225.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1393.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1225.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":805.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":582.28,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":537.28,"methodology":"fee schedule"}]}]},{"description":"TESTICULAR IMAGING W FLOW","code_information":[{"code":"78761","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1127.12,"maximum":1482.24,"gross_charge":1544,"discounted_cash":895.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1466.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1482.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1127.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1281.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1127.12,"methodology":"fee schedule"}]}]},{"description":"TESTICULAR IMAGING W FLOW","code_information":[{"code":"78761","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":494.08,"maximum":1482.24,"gross_charge":1544,"discounted_cash":895.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1466.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1482.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1127.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1281.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1127.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":741.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":535.46,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":494.08,"methodology":"fee schedule"}]}]},{"description":"TUMOR IMAGE SPECT","code_information":[{"code":"78803","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":1105.95,"maximum":1454.4,"gross_charge":1515,"discounted_cash":878.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1439.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1454.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1105.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1257.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1105.95,"methodology":"fee schedule"}]}]},{"description":"TUMOR IMAGE SPECT","code_information":[{"code":"78803","type":"CPT"},{"code":"0341","type":"RC"}],"standard_charges":[{"minimum":484.8,"maximum":1454.4,"gross_charge":1515,"discounted_cash":878.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":1439.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":1454.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":1105.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":1257.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":1105.95,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":727.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":525.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":484.8,"methodology":"fee schedule"}]}]},{"description":"EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7921","type":"APR-DRG"}],"standard_charges":[{"minimum":32764,"maximum":32764,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32764,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7922","type":"APR-DRG"}],"standard_charges":[{"minimum":57591,"maximum":57591,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":57591,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7923","type":"APR-DRG"}],"standard_charges":[{"minimum":76486,"maximum":76486,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":76486,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7924","type":"APR-DRG"}],"standard_charges":[{"minimum":153224,"maximum":153224,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":153224,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7931","type":"APR-DRG"}],"standard_charges":[{"minimum":22340,"maximum":22340,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":22340,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7932","type":"APR-DRG"}],"standard_charges":[{"minimum":32756,"maximum":32756,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":32756,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7933","type":"APR-DRG"}],"standard_charges":[{"minimum":44774,"maximum":44774,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":44774,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7934","type":"APR-DRG"}],"standard_charges":[{"minimum":105311,"maximum":105311,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":105311,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7941","type":"APR-DRG"}],"standard_charges":[{"minimum":15875,"maximum":15875,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":15875,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7942","type":"APR-DRG"}],"standard_charges":[{"minimum":25425,"maximum":25425,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":25425,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7943","type":"APR-DRG"}],"standard_charges":[{"minimum":41249,"maximum":41249,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":41249,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT","code_information":[{"code":"7944","type":"APR-DRG"}],"standard_charges":[{"minimum":69275,"maximum":69275,"setting":"inpatient","payers_information":[{"payer_name":"BCBS - ND","plan_name":"Commercial|All Plans","standard_charge_dollar":69275,"methodology":"case rate"},{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_percentage":95,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_percentage":96,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_percentage":83,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_percentage":73,"count":"0","methodology":"percent of total billed charges", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":3835,"methodology":"per diem"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":2794,"methodology":"per diem"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":2854,"methodology":"per diem"}]}]},{"description":"BMP POC","code_information":[{"code":"80047","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":97.09,"maximum":127.68,"gross_charge":133,"discounted_cash":77.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":126.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":127.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":97.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":110.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":97.09,"methodology":"fee schedule"}]}]},{"description":"BMP POC","code_information":[{"code":"80047","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.73,"maximum":127.68,"gross_charge":133,"discounted_cash":77.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":126.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":127.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":97.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":110.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":97.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":63.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14,"standard_charge_algorithm": "Lesser of $14.00 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.73,"standard_charge_algorithm": "Lesser of $13.73 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"BMP","code_information":[{"code":"80048","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":113.15,"maximum":148.8,"gross_charge":155,"discounted_cash":89.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":147.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":148.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":113.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":128.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":113.15,"methodology":"fee schedule"}]}]},{"description":"BMP","code_information":[{"code":"80048","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.46,"maximum":148.8,"gross_charge":155,"discounted_cash":89.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":147.25,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":148.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":113.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":128.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":113.15,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":74.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":8.63,"standard_charge_algorithm": "Lesser of $8.63 or 102 Percent of Billed Charges","median_amount":53.75,"10th_percentile":8.63,"90th_percentile":53.76,"count":"79","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.46,"standard_charge_algorithm": "Lesser of $8.46 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"GENERAL HEALTH PANEL","code_information":[{"code":"80050","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":289.08,"maximum":380.16,"gross_charge":396,"discounted_cash":229.68,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":376.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":380.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":289.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":328.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":289.08,"methodology":"fee schedule"}]}]},{"description":"GENERAL HEALTH PANEL","code_information":[{"code":"80050","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":126.72,"maximum":380.16,"gross_charge":396,"discounted_cash":229.68,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":376.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":380.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":289.08,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":328.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":289.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":190.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":137.34,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":126.72,"methodology":"fee schedule"}]}]},{"description":"ELECTROLYTES","code_information":[{"code":"80051","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":89.06,"maximum":117.12,"gross_charge":122,"discounted_cash":70.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":115.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":117.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":89.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":101.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":89.06,"methodology":"fee schedule"}]}]},{"description":"ELECTROLYTES","code_information":[{"code":"80051","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":7.01,"maximum":117.12,"gross_charge":122,"discounted_cash":70.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":115.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":117.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":89.06,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":101.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":89.06,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":58.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":7.15,"standard_charge_algorithm": "Lesser of $7.15 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":7.01,"standard_charge_algorithm": "Lesser of $7.01 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CMP","code_information":[{"code":"80053","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":178.12,"maximum":234.24,"gross_charge":244,"discounted_cash":141.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":231.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":234.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":178.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":202.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":178.12,"methodology":"fee schedule"}]}]},{"description":"CMP","code_information":[{"code":"80053","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":10.56,"maximum":234.24,"gross_charge":244,"discounted_cash":141.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":231.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":234.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":178.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":202.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":178.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":117.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":10.77,"standard_charge_algorithm": "Lesser of $10.77 or 102 Percent of Billed Charges","median_amount":84.62,"10th_percentile":79.64,"90th_percentile":84.62,"count":"183","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":10.56,"standard_charge_algorithm": "Lesser of $10.56 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"LIPID PNL","code_information":[{"code":"80061","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":44.53,"maximum":58.56,"gross_charge":61,"discounted_cash":35.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":57.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":58.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":44.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":44.53,"methodology":"fee schedule"}]}]},{"description":"LIPID PNL","code_information":[{"code":"80061","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.39,"maximum":58.56,"gross_charge":61,"discounted_cash":35.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":57.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":58.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":44.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":44.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":29.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.66,"standard_charge_algorithm": "Lesser of $13.66 or 102 Percent of Billed Charges","median_amount":71.44,"10th_percentile":67.24,"90th_percentile":75.95,"count":"110","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.39,"standard_charge_algorithm": "Lesser of $13.39 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"LIPID PROFILE","code_information":[{"code":"80061","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":159.87,"maximum":210.24,"gross_charge":219,"discounted_cash":127.02,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":208.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":210.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":159.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":159.87,"methodology":"fee schedule"}]}]},{"description":"LIPID PROFILE","code_information":[{"code":"80061","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.39,"maximum":210.24,"gross_charge":219,"discounted_cash":127.02,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":208.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":210.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":159.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":181.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":159.87,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":105.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.66,"standard_charge_algorithm": "Lesser of $13.66 or 102 Percent of Billed Charges","median_amount":71.44,"10th_percentile":67.24,"90th_percentile":75.95,"count":"110","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.39,"standard_charge_algorithm": "Lesser of $13.39 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"RENAL FUNCTION PANEL","code_information":[{"code":"80069","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":137.24,"maximum":180.48,"gross_charge":188,"discounted_cash":109.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":178.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":180.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":137.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":156.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":137.24,"methodology":"fee schedule"}]}]},{"description":"RENAL FUNCTION PANEL","code_information":[{"code":"80069","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.68,"maximum":180.48,"gross_charge":188,"discounted_cash":109.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":178.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":180.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":137.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":156.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":137.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":90.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":8.85,"standard_charge_algorithm": "Lesser of $8.85 or 102 Percent of Billed Charges","median_amount":67.29,"10th_percentile":67.29,"90th_percentile":67.29,"count":"1 through 10","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.68,"standard_charge_algorithm": "Lesser of $8.68 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"RENAL PROFILE","code_information":[{"code":"80069","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":141.62,"maximum":186.24,"gross_charge":194,"discounted_cash":112.52,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":184.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":186.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":141.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":161.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":141.62,"methodology":"fee schedule"}]}]},{"description":"RENAL PROFILE","code_information":[{"code":"80069","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.68,"maximum":186.24,"gross_charge":194,"discounted_cash":112.52,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":184.3,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":186.24,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":141.62,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":161.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":141.62,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":93.12,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":8.85,"standard_charge_algorithm": "Lesser of $8.85 or 102 Percent of Billed Charges","median_amount":67.29,"10th_percentile":67.29,"90th_percentile":67.29,"count":"1 through 10","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.68,"standard_charge_algorithm": "Lesser of $8.68 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"HEPATITIS ACUTE W HCV NAA RFL","code_information":[{"code":"80074","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":104.31,"maximum":137.18,"gross_charge":142.89,"discounted_cash":82.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":135.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":137.18,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":104.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":118.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":104.31,"methodology":"fee schedule"}]}]},{"description":"HEPATITIS ACUTE W HCV NAA RFL","code_information":[{"code":"80074","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":47.63,"maximum":137.18,"gross_charge":142.89,"discounted_cash":82.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":135.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":137.18,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":104.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":118.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":104.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":68.59,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":48.58,"standard_charge_algorithm": "Lesser of $48.58 or 102 Percent of Billed Charges","median_amount":49.55,"10th_percentile":49.55,"90th_percentile":49.55,"count":"1 through 10","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.63,"standard_charge_algorithm": "Lesser of $47.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"HEPATITIS PANEL ACUTE","code_information":[{"code":"80074","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":356.24,"maximum":468.48,"gross_charge":488,"discounted_cash":283.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":463.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":468.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":356.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":405.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":356.24,"methodology":"fee schedule"}]}]},{"description":"HEPATITIS PANEL ACUTE","code_information":[{"code":"80074","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":47.63,"maximum":468.48,"gross_charge":488,"discounted_cash":283.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":463.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":468.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":356.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":405.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":356.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":234.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":48.58,"standard_charge_algorithm": "Lesser of $48.58 or 102 Percent of Billed Charges","median_amount":49.55,"10th_percentile":49.55,"90th_percentile":49.55,"count":"1 through 10","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.63,"standard_charge_algorithm": "Lesser of $47.63 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"HEPATIC FUNCTION","code_information":[{"code":"80076","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":150.38,"maximum":197.76,"gross_charge":206,"discounted_cash":119.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":195.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":197.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":170.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":150.38,"methodology":"fee schedule"}]}]},{"description":"HEPATIC FUNCTION","code_information":[{"code":"80076","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.17,"maximum":197.76,"gross_charge":206,"discounted_cash":119.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":195.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":197.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":170.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":8.33,"standard_charge_algorithm": "Lesser of $8.33 or 102 Percent of Billed Charges","median_amount":71.44,"10th_percentile":8.33,"90th_percentile":71.44,"count":"1 through 10","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.17,"standard_charge_algorithm": "Lesser of $8.17 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"HEPATIC FUNCTION PANEL","code_information":[{"code":"80076","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":146,"maximum":192,"gross_charge":200,"discounted_cash":116,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":190,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":192,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":146,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":166,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":146,"methodology":"fee schedule"}]}]},{"description":"HEPATIC FUNCTION PANEL","code_information":[{"code":"80076","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.17,"maximum":192,"gross_charge":200,"discounted_cash":116,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":190,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":192,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":146,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":166,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":146,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":8.33,"standard_charge_algorithm": "Lesser of $8.33 or 102 Percent of Billed Charges","median_amount":71.44,"10th_percentile":8.33,"90th_percentile":71.44,"count":"1 through 10","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.17,"standard_charge_algorithm": "Lesser of $8.17 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ACETAMINOPHEN","code_information":[{"code":"80143","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.5,"maximum":144,"gross_charge":150,"discounted_cash":87,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":142.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":109.5,"methodology":"fee schedule"}]}]},{"description":"ACETAMINOPHEN","code_information":[{"code":"80143","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":144,"gross_charge":150,"discounted_cash":87,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":142.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ACETAMINOPHEN","code_information":[{"code":"80143","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":435.81,"maximum":573.12,"gross_charge":597,"discounted_cash":346.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":567.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":573.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":495.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.81,"methodology":"fee schedule"}]}]},{"description":"ACETAMINOPHEN","code_information":[{"code":"80143","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":573.12,"gross_charge":597,"discounted_cash":346.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":567.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":573.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":495.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ADALIMUMAB DRUG LEVEL","code_information":[{"code":"80145","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":154.76,"maximum":203.52,"gross_charge":212,"discounted_cash":122.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":201.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":203.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":154.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":175.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":154.76,"methodology":"fee schedule"}]}]},{"description":"ADALIMUMAB DRUG LEVEL","code_information":[{"code":"80145","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":38.57,"maximum":203.52,"gross_charge":212,"discounted_cash":122.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":201.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":203.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":154.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":175.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":154.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":101.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":39.34,"standard_charge_algorithm": "Lesser of $39.34 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":38.57,"standard_charge_algorithm": "Lesser of $38.57 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"AMIKACIN SINGLE","code_information":[{"code":"80150","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":122.64,"maximum":161.28,"gross_charge":168,"discounted_cash":97.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":159.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":161.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":122.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":139.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":122.64,"methodology":"fee schedule"}]}]},{"description":"AMIKACIN SINGLE","code_information":[{"code":"80150","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":15.08,"maximum":161.28,"gross_charge":168,"discounted_cash":97.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":159.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":161.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":122.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":139.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":122.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":80.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":15.38,"standard_charge_algorithm": "Lesser of $15.38 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":15.08,"standard_charge_algorithm": "Lesser of $15.08 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"AMIODARONE","code_information":[{"code":"80151","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":113.88,"maximum":149.76,"gross_charge":156,"discounted_cash":90.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":148.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":149.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":113.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":129.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":113.88,"methodology":"fee schedule"}]}]},{"description":"AMIODARONE","code_information":[{"code":"80151","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":149.76,"gross_charge":156,"discounted_cash":90.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":148.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":149.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":113.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":129.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":113.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":74.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"AMIODARONE AND METABOLITE","code_information":[{"code":"80151","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":40.83,"maximum":53.69,"gross_charge":55.92,"discounted_cash":32.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":53.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":53.69,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.83,"methodology":"fee schedule"}]}]},{"description":"AMIODARONE AND METABOLITE","code_information":[{"code":"80151","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":53.69,"gross_charge":55.92,"discounted_cash":32.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":53.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":53.69,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CARBAMAZEPINE (TEGRETOL)","code_information":[{"code":"80156","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":125.56,"maximum":165.12,"gross_charge":172,"discounted_cash":99.76,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":163.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":165.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":125.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":142.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":125.56,"methodology":"fee schedule"}]}]},{"description":"CARBAMAZEPINE (TEGRETOL)","code_information":[{"code":"80156","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":14.57,"maximum":165.12,"gross_charge":172,"discounted_cash":99.76,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":163.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":165.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":125.56,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":142.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":125.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":82.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.86,"standard_charge_algorithm": "Lesser of $14.86 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":14.57,"standard_charge_algorithm": "Lesser of $14.57 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CARBAMAZEPINE TOTAL","code_information":[{"code":"80156","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":31.91,"maximum":41.97,"gross_charge":43.71,"discounted_cash":25.36,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":41.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":41.97,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":31.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":31.91,"methodology":"fee schedule"}]}]},{"description":"CARBAMAZEPINE TOTAL","code_information":[{"code":"80156","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":14.57,"maximum":41.97,"gross_charge":43.71,"discounted_cash":25.36,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":41.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":41.97,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":31.91,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":36.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":31.91,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":20.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.86,"standard_charge_algorithm": "Lesser of $14.86 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":14.57,"standard_charge_algorithm": "Lesser of $14.57 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"FREE CARBAMAZEPINE","code_information":[{"code":"80157","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":29.02,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"}]}]},{"description":"FREE CARBAMAZEPINE","code_information":[{"code":"80157","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.25,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.52,"standard_charge_algorithm": "Lesser of $13.52 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.25,"standard_charge_algorithm": "Lesser of $13.25 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CYCLOSPORINE TDX (HEART TRANSP","code_information":[{"code":"80158","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":147.46,"maximum":193.92,"gross_charge":202,"discounted_cash":117.16,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":191.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":193.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":147.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":167.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":147.46,"methodology":"fee schedule"}]}]},{"description":"CYCLOSPORINE TDX (HEART TRANSP","code_information":[{"code":"80158","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.05,"maximum":193.92,"gross_charge":202,"discounted_cash":117.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":191.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":193.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":147.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":167.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":147.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":96.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":18.41,"standard_charge_algorithm": "Lesser of $18.41 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.05,"standard_charge_algorithm": "Lesser of $18.05 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CLOZAPINE","code_information":[{"code":"80159","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":150.38,"maximum":197.76,"gross_charge":206,"discounted_cash":119.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":195.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":197.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":170.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":150.38,"methodology":"fee schedule"}]}]},{"description":"CLOZAPINE","code_information":[{"code":"80159","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":20.15,"maximum":197.76,"gross_charge":206,"discounted_cash":119.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":195.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":197.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":170.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":150.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":20.55,"standard_charge_algorithm": "Lesser of $20.55 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":20.15,"standard_charge_algorithm": "Lesser of $20.15 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CLOZAPINE AND METAB S/P QUANT","code_information":[{"code":"80159","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":44.13,"maximum":58.04,"gross_charge":60.45,"discounted_cash":35.07,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":57.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":58.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":44.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":44.13,"methodology":"fee schedule"}]}]},{"description":"CLOZAPINE AND METAB S/P QUANT","code_information":[{"code":"80159","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":20.15,"maximum":58.04,"gross_charge":60.45,"discounted_cash":35.07,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":57.43,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":58.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":44.13,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":50.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":44.13,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":20.55,"standard_charge_algorithm": "Lesser of $20.55 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":20.15,"standard_charge_algorithm": "Lesser of $20.15 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"DIGOXIN","code_information":[{"code":"80162","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":120.45,"maximum":158.4,"gross_charge":165,"discounted_cash":95.7,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":156.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":158.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":120.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":136.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":120.45,"methodology":"fee schedule"}]}]},{"description":"DIGOXIN","code_information":[{"code":"80162","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.28,"maximum":158.4,"gross_charge":165,"discounted_cash":95.7,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":156.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":158.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":120.45,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":136.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":120.45,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":79.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.55,"standard_charge_algorithm": "Lesser of $13.55 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.28,"standard_charge_algorithm": "Lesser of $13.28 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VALPROIC ACID","code_information":[{"code":"80164","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":29.66,"maximum":39,"gross_charge":40.62,"discounted_cash":23.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.66,"methodology":"fee schedule"}]}]},{"description":"VALPROIC ACID","code_information":[{"code":"80164","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.54,"maximum":39,"gross_charge":40.62,"discounted_cash":23.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.81,"standard_charge_algorithm": "Lesser of $13.81 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.54,"standard_charge_algorithm": "Lesser of $13.54 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VALPROIC ACID (DEPAKENE)","code_information":[{"code":"80164","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":130.67,"maximum":171.84,"gross_charge":179,"discounted_cash":103.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":170.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":171.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":130.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":148.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":130.67,"methodology":"fee schedule"}]}]},{"description":"VALPROIC ACID (DEPAKENE)","code_information":[{"code":"80164","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.54,"maximum":171.84,"gross_charge":179,"discounted_cash":103.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":170.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":171.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":130.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":148.57,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":130.67,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":85.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.81,"standard_charge_algorithm": "Lesser of $13.81 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.54,"standard_charge_algorithm": "Lesser of $13.54 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VALPROIC ACID FREE","code_information":[{"code":"80165","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":29.66,"maximum":39,"gross_charge":40.62,"discounted_cash":23.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.66,"methodology":"fee schedule"}]}]},{"description":"VALPROIC ACID FREE","code_information":[{"code":"80165","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.54,"maximum":39,"gross_charge":40.62,"discounted_cash":23.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":38.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.66,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.66,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.81,"standard_charge_algorithm": "Lesser of $13.81 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.54,"standard_charge_algorithm": "Lesser of $13.54 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VALPROIC ACID FREE","code_information":[{"code":"80165","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":77.38,"maximum":101.76,"gross_charge":106,"discounted_cash":61.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":100.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":101.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":77.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":87.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":77.38,"methodology":"fee schedule"}]}]},{"description":"VALPROIC ACID FREE","code_information":[{"code":"80165","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.54,"maximum":101.76,"gross_charge":106,"discounted_cash":61.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":100.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":101.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":77.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":87.98,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":77.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":50.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.81,"standard_charge_algorithm": "Lesser of $13.81 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.54,"standard_charge_algorithm": "Lesser of $13.54 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"FELBAMATE","code_information":[{"code":"80167","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":113.88,"maximum":149.76,"gross_charge":156,"discounted_cash":90.48,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":148.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":149.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":113.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":129.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":113.88,"methodology":"fee schedule"}]}]},{"description":"FELBAMATE","code_information":[{"code":"80167","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":149.76,"gross_charge":156,"discounted_cash":90.48,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":148.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":149.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":113.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":129.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":113.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":74.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"FELBAMATE (FELBATOL)","code_information":[{"code":"80167","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":40.83,"maximum":53.69,"gross_charge":55.92,"discounted_cash":32.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":53.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":53.69,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.83,"methodology":"fee schedule"}]}]},{"description":"FELBAMATE (FELBATOL)","code_information":[{"code":"80167","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":53.69,"gross_charge":55.92,"discounted_cash":32.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":53.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":53.69,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ETHOSUXIMIDE","code_information":[{"code":"80168","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":35.79,"maximum":47.06,"gross_charge":49.02,"discounted_cash":28.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":46.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.06,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.79,"methodology":"fee schedule"}]}]},{"description":"ETHOSUXIMIDE","code_information":[{"code":"80168","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":16.34,"maximum":47.06,"gross_charge":49.02,"discounted_cash":28.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":46.57,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.06,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.79,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.67,"standard_charge_algorithm": "Lesser of $16.67 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.34,"standard_charge_algorithm": "Lesser of $16.34 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ETHOSUXIMIDE","code_information":[{"code":"80168","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":133.59,"maximum":175.68,"gross_charge":183,"discounted_cash":106.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":173.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":175.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":133.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":151.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":133.59,"methodology":"fee schedule"}]}]},{"description":"ETHOSUXIMIDE","code_information":[{"code":"80168","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":16.34,"maximum":175.68,"gross_charge":183,"discounted_cash":106.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":173.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":175.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":133.59,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":151.89,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":133.59,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":87.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.67,"standard_charge_algorithm": "Lesser of $16.67 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.34,"standard_charge_algorithm": "Lesser of $16.34 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"GENTAMICIN","code_information":[{"code":"80170","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":151.11,"maximum":198.72,"gross_charge":207,"discounted_cash":120.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":196.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":198.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":151.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":171.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":151.11,"methodology":"fee schedule"}]}]},{"description":"GENTAMICIN","code_information":[{"code":"80170","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":16.38,"maximum":198.72,"gross_charge":207,"discounted_cash":120.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":196.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":198.72,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":151.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":171.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":151.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":99.36,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.71,"standard_charge_algorithm": "Lesser of $16.71 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.38,"standard_charge_algorithm": "Lesser of $16.38 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"GENTAMICIN PEAK LEVEL","code_information":[{"code":"80170","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":35.88,"maximum":47.18,"gross_charge":49.14,"discounted_cash":28.51,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":46.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.18,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.88,"methodology":"fee schedule"}]}]},{"description":"GENTAMICIN PEAK LEVEL","code_information":[{"code":"80170","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":16.38,"maximum":47.18,"gross_charge":49.14,"discounted_cash":28.51,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":46.69,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.18,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.88,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40.79,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.88,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.59,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.71,"standard_charge_algorithm": "Lesser of $16.71 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.38,"standard_charge_algorithm": "Lesser of $16.38 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"GABAPENTIN","code_information":[{"code":"80171","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":154.76,"maximum":203.52,"gross_charge":212,"discounted_cash":122.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":201.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":203.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":154.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":175.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":154.76,"methodology":"fee schedule"}]}]},{"description":"GABAPENTIN","code_information":[{"code":"80171","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":21.67,"maximum":203.52,"gross_charge":212,"discounted_cash":122.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":201.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":203.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":154.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":175.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":154.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":101.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":22.1,"standard_charge_algorithm": "Lesser of $22.10 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":21.67,"standard_charge_algorithm": "Lesser of $21.67 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"GABAPENTIN LEVEL","code_information":[{"code":"80171","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":47.46,"maximum":62.41,"gross_charge":65.01,"discounted_cash":37.71,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":61.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":62.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":47.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":53.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":47.46,"methodology":"fee schedule"}]}]},{"description":"GABAPENTIN LEVEL","code_information":[{"code":"80171","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":21.67,"maximum":62.41,"gross_charge":65.01,"discounted_cash":37.71,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":61.76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":62.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":47.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":53.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":47.46,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":31.21,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":22.1,"standard_charge_algorithm": "Lesser of $22.10 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":21.67,"standard_charge_algorithm": "Lesser of $21.67 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"LAMOTRIGINE","code_information":[{"code":"80175","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":131.4,"maximum":172.8,"gross_charge":180,"discounted_cash":104.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":171,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":172.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":131.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":149.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":131.4,"methodology":"fee schedule"}]}]},{"description":"LAMOTRIGINE","code_information":[{"code":"80175","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.25,"maximum":172.8,"gross_charge":180,"discounted_cash":104.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":171,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":172.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":131.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":149.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":131.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":86.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.52,"standard_charge_algorithm": "Lesser of $13.52 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.25,"standard_charge_algorithm": "Lesser of $13.25 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"LAMOTRIGINE/LAMICTAL","code_information":[{"code":"80175","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":29.02,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"}]}]},{"description":"LAMOTRIGINE/LAMICTAL","code_information":[{"code":"80175","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.25,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.52,"standard_charge_algorithm": "Lesser of $13.52 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.25,"standard_charge_algorithm": "Lesser of $13.25 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"KEPPRA","code_information":[{"code":"80177","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":118.26,"maximum":155.52,"gross_charge":162,"discounted_cash":93.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":153.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":155.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":118.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":134.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":118.26,"methodology":"fee schedule"}]}]},{"description":"KEPPRA","code_information":[{"code":"80177","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.25,"maximum":155.52,"gross_charge":162,"discounted_cash":93.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":153.9,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":155.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":118.26,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":134.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":118.26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":77.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.52,"standard_charge_algorithm": "Lesser of $13.52 or 102 Percent of Billed Charges","median_amount":13.52,"10th_percentile":13.52,"90th_percentile":13.52,"count":"1 through 10","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.25,"standard_charge_algorithm": "Lesser of $13.25 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"KEPPRA (LEVETIRACETAM)","code_information":[{"code":"80177","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":29.02,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"}]}]},{"description":"KEPPRA (LEVETIRACETAM)","code_information":[{"code":"80177","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.25,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.52,"standard_charge_algorithm": "Lesser of $13.52 or 102 Percent of Billed Charges","median_amount":13.52,"10th_percentile":13.52,"90th_percentile":13.52,"count":"1 through 10","methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.25,"standard_charge_algorithm": "Lesser of $13.25 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"LITHIUM","code_information":[{"code":"80178","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":73,"maximum":96,"gross_charge":100,"discounted_cash":58,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":73,"methodology":"fee schedule"}]}]},{"description":"LITHIUM","code_information":[{"code":"80178","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":6.61,"maximum":96,"gross_charge":100,"discounted_cash":58,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":96,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":73,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.74,"standard_charge_algorithm": "Lesser of $6.74 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":6.61,"standard_charge_algorithm": "Lesser of $6.61 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"LITHIUM SERUM OR PLASMA","code_information":[{"code":"80178","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":14.48,"maximum":19.04,"gross_charge":19.83,"discounted_cash":11.51,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":18.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":19.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":14.48,"methodology":"fee schedule"}]}]},{"description":"LITHIUM SERUM OR PLASMA","code_information":[{"code":"80178","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":6.61,"maximum":19.04,"gross_charge":19.83,"discounted_cash":11.51,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":18.84,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":19.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":14.48,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":16.46,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":14.48,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":9.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":6.74,"standard_charge_algorithm": "Lesser of $6.74 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":6.61,"standard_charge_algorithm": "Lesser of $6.61 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"SALICYLATE","code_information":[{"code":"80179","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.5,"maximum":144,"gross_charge":150,"discounted_cash":87,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":142.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":109.5,"methodology":"fee schedule"}]}]},{"description":"SALICYLATE","code_information":[{"code":"80179","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":144,"gross_charge":150,"discounted_cash":87,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":142.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":144,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":124.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":109.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"SALICYLATE","code_information":[{"code":"80179","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":435.81,"maximum":573.12,"gross_charge":597,"discounted_cash":346.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":567.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":573.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":495.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.81,"methodology":"fee schedule"}]}]},{"description":"SALICYLATE","code_information":[{"code":"80179","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":573.12,"gross_charge":597,"discounted_cash":346.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":567.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":573.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":495.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"MYCOPHENOLIC ACID AND METAB","code_information":[{"code":"80180","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":39.53,"maximum":51.99,"gross_charge":54.15,"discounted_cash":31.41,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":51.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":51.99,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":39.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":44.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":39.53,"methodology":"fee schedule"}]}]},{"description":"MYCOPHENOLIC ACID AND METAB","code_information":[{"code":"80180","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.05,"maximum":51.99,"gross_charge":54.15,"discounted_cash":31.41,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":51.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":51.99,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":39.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":44.95,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":39.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":26,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":18.41,"standard_charge_algorithm": "Lesser of $18.41 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.05,"standard_charge_algorithm": "Lesser of $18.05 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"OXCARBAZEP ESLICARBAZEPINE MTB","code_information":[{"code":"80183","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":29.02,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"}]}]},{"description":"OXCARBAZEP ESLICARBAZEPINE MTB","code_information":[{"code":"80183","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.25,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.52,"standard_charge_algorithm": "Lesser of $13.52 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.25,"standard_charge_algorithm": "Lesser of $13.25 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"OXCARBAZEPINE METABOLITE","code_information":[{"code":"80183","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":108.04,"maximum":142.08,"gross_charge":148,"discounted_cash":85.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":140.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.04,"methodology":"fee schedule"}]}]},{"description":"OXCARBAZEPINE METABOLITE","code_information":[{"code":"80183","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.25,"maximum":142.08,"gross_charge":148,"discounted_cash":85.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":140.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.52,"standard_charge_algorithm": "Lesser of $13.52 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.25,"standard_charge_algorithm": "Lesser of $13.25 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"PHENOBARBITAL","code_information":[{"code":"80184","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":33.51,"maximum":44.07,"gross_charge":45.9,"discounted_cash":26.63,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":43.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":44.07,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":33.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":38.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":33.51,"methodology":"fee schedule"}]}]},{"description":"PHENOBARBITAL","code_information":[{"code":"80184","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":15.3,"maximum":44.07,"gross_charge":45.9,"discounted_cash":26.63,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":43.61,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":44.07,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":33.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":38.1,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":33.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":22.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":15.61,"standard_charge_algorithm": "Lesser of $15.61 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":15.3,"standard_charge_algorithm": "Lesser of $15.30 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"PHENOBARBITAL","code_information":[{"code":"80184","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":167.17,"maximum":219.84,"gross_charge":229,"discounted_cash":132.82,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":217.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":219.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":167.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":190.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":167.17,"methodology":"fee schedule"}]}]},{"description":"PHENOBARBITAL","code_information":[{"code":"80184","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":15.3,"maximum":219.84,"gross_charge":229,"discounted_cash":132.82,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":217.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":219.84,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":167.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":190.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":167.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":109.92,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":15.61,"standard_charge_algorithm": "Lesser of $15.61 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":15.3,"standard_charge_algorithm": "Lesser of $15.30 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"PHENYTOIN - TOTAL","code_information":[{"code":"80185","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":29.02,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"}]}]},{"description":"PHENYTOIN - TOTAL","code_information":[{"code":"80185","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.25,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.52,"standard_charge_algorithm": "Lesser of $13.52 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.25,"standard_charge_algorithm": "Lesser of $13.25 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"PHENYTOIN (DILANTIN)","code_information":[{"code":"80185","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":138.7,"maximum":182.4,"gross_charge":190,"discounted_cash":110.2,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":180.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":182.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":138.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":157.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":138.7,"methodology":"fee schedule"}]}]},{"description":"PHENYTOIN (DILANTIN)","code_information":[{"code":"80185","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.25,"maximum":182.4,"gross_charge":190,"discounted_cash":110.2,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":180.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":182.4,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":138.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":157.7,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":138.7,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":91.2,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.52,"standard_charge_algorithm": "Lesser of $13.52 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.25,"standard_charge_algorithm": "Lesser of $13.25 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"PHENYTOIN - FREE LEVEL","code_information":[{"code":"80186","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":30.14,"maximum":39.63,"gross_charge":41.28,"discounted_cash":23.95,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":39.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.63,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":30.14,"methodology":"fee schedule"}]}]},{"description":"PHENYTOIN - FREE LEVEL","code_information":[{"code":"80186","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.76,"maximum":39.63,"gross_charge":41.28,"discounted_cash":23.95,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":39.22,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.63,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30.14,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.27,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":30.14,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.82,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.04,"standard_charge_algorithm": "Lesser of $14.04 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.76,"standard_charge_algorithm": "Lesser of $13.76 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"POSACONAZOLE QUANT","code_information":[{"code":"80187","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":59.38,"maximum":78.08,"gross_charge":81.33,"discounted_cash":47.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":77.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":78.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":59.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":59.38,"methodology":"fee schedule"}]}]},{"description":"POSACONAZOLE QUANT","code_information":[{"code":"80187","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":27.11,"maximum":78.08,"gross_charge":81.33,"discounted_cash":47.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":77.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":78.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":59.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":59.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":27.65,"standard_charge_algorithm": "Lesser of $27.65 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":27.11,"standard_charge_algorithm": "Lesser of $27.11 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"PRIMIDONE","code_information":[{"code":"80188","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":36.34,"maximum":47.78,"gross_charge":49.77,"discounted_cash":28.87,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":47.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.78,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":36.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":36.34,"methodology":"fee schedule"}]}]},{"description":"PRIMIDONE","code_information":[{"code":"80188","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":16.59,"maximum":47.78,"gross_charge":49.77,"discounted_cash":28.87,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":47.29,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":47.78,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":36.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":41.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":36.34,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.89,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.92,"standard_charge_algorithm": "Lesser of $16.92 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.59,"standard_charge_algorithm": "Lesser of $16.59 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"PRIMIDONE","code_information":[{"code":"80188","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":149.65,"maximum":196.8,"gross_charge":205,"discounted_cash":118.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":194.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":196.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":149.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":170.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":149.65,"methodology":"fee schedule"}]}]},{"description":"PRIMIDONE","code_information":[{"code":"80188","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":16.59,"maximum":196.8,"gross_charge":205,"discounted_cash":118.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":194.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":196.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":149.65,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":170.15,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":149.65,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":98.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.92,"standard_charge_algorithm": "Lesser of $16.92 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.59,"standard_charge_algorithm": "Lesser of $16.59 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"SIROLIMUS","code_information":[{"code":"80195","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":111.69,"maximum":146.88,"gross_charge":153,"discounted_cash":88.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":145.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":146.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":111.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":111.69,"methodology":"fee schedule"}]}]},{"description":"SIROLIMUS","code_information":[{"code":"80195","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.73,"maximum":146.88,"gross_charge":153,"discounted_cash":88.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":145.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":146.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":111.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":111.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14,"standard_charge_algorithm": "Lesser of $14.00 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.73,"standard_charge_algorithm": "Lesser of $13.73 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"SIROLIMUS BY TANDEM MASS SPEC","code_information":[{"code":"80195","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":30.07,"maximum":39.55,"gross_charge":41.19,"discounted_cash":23.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":39.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.55,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":30.07,"methodology":"fee schedule"}]}]},{"description":"SIROLIMUS BY TANDEM MASS SPEC","code_information":[{"code":"80195","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.73,"maximum":39.55,"gross_charge":41.19,"discounted_cash":23.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":39.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.55,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":30.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14,"standard_charge_algorithm": "Lesser of $14.00 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.73,"standard_charge_algorithm": "Lesser of $13.73 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"TACROLIMUS","code_information":[{"code":"80197","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":111.69,"maximum":146.88,"gross_charge":153,"discounted_cash":88.74,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":145.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":146.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":111.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":111.69,"methodology":"fee schedule"}]}]},{"description":"TACROLIMUS","code_information":[{"code":"80197","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.73,"maximum":146.88,"gross_charge":153,"discounted_cash":88.74,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":145.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":146.88,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":111.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":111.69,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":73.44,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14,"standard_charge_algorithm": "Lesser of $14.00 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.73,"standard_charge_algorithm": "Lesser of $13.73 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"TACROLIMUS (FK506)","code_information":[{"code":"80197","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":30.07,"maximum":39.55,"gross_charge":41.19,"discounted_cash":23.9,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":39.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.55,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":30.07,"methodology":"fee schedule"}]}]},{"description":"TACROLIMUS (FK506)","code_information":[{"code":"80197","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.73,"maximum":39.55,"gross_charge":41.19,"discounted_cash":23.9,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":39.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":39.55,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":30.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":34.19,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":30.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14,"standard_charge_algorithm": "Lesser of $14.00 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.73,"standard_charge_algorithm": "Lesser of $13.73 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"THEOPHYLLINE (AMINOPHYLLINE)","code_information":[{"code":"80198","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":116.07,"maximum":152.64,"gross_charge":159,"discounted_cash":92.22,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":151.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.07,"methodology":"fee schedule"}]}]},{"description":"THEOPHYLLINE (AMINOPHYLLINE)","code_information":[{"code":"80198","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":14.14,"maximum":152.64,"gross_charge":159,"discounted_cash":92.22,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":151.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":152.64,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.07,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":131.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.07,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":14.42,"standard_charge_algorithm": "Lesser of $14.42 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":14.14,"standard_charge_algorithm": "Lesser of $14.14 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"TOBRAMYCIN PEAK","code_information":[{"code":"80200","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":135.05,"maximum":177.6,"gross_charge":185,"discounted_cash":107.3,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":175.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":177.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":153.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":135.05,"methodology":"fee schedule"}]}]},{"description":"TOBRAMYCIN PEAK","code_information":[{"code":"80200","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":16.13,"maximum":177.6,"gross_charge":185,"discounted_cash":107.3,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":175.75,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":177.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.05,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":153.55,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":135.05,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":88.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.45,"standard_charge_algorithm": "Lesser of $16.45 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.13,"standard_charge_algorithm": "Lesser of $16.13 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"TOBRAMYCIN TROUGH LEVEL","code_information":[{"code":"80200","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":35.33,"maximum":46.46,"gross_charge":48.39,"discounted_cash":28.07,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":45.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":46.46,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.33,"methodology":"fee schedule"}]}]},{"description":"TOBRAMYCIN TROUGH LEVEL","code_information":[{"code":"80200","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":16.13,"maximum":46.46,"gross_charge":48.39,"discounted_cash":28.07,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":45.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":46.46,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":35.33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":40.17,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":35.33,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":23.23,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":16.45,"standard_charge_algorithm": "Lesser of $16.45 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":16.13,"standard_charge_algorithm": "Lesser of $16.13 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"TOPIRAMATE","code_information":[{"code":"80201","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":26.11,"maximum":34.33,"gross_charge":35.76,"discounted_cash":20.75,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":33.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":34.33,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":26.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":26.11,"methodology":"fee schedule"}]}]},{"description":"TOPIRAMATE","code_information":[{"code":"80201","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":11.92,"maximum":34.33,"gross_charge":35.76,"discounted_cash":20.75,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":33.98,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":34.33,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":26.11,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":29.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":26.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":17.17,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":12.16,"standard_charge_algorithm": "Lesser of $12.16 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":11.92,"standard_charge_algorithm": "Lesser of $11.92 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"TOPIRAMATE","code_information":[{"code":"80201","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":97.09,"maximum":127.68,"gross_charge":133,"discounted_cash":77.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":126.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":127.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":97.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":110.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":97.09,"methodology":"fee schedule"}]}]},{"description":"TOPIRAMATE","code_information":[{"code":"80201","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":11.92,"maximum":127.68,"gross_charge":133,"discounted_cash":77.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":126.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":127.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":97.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":110.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":97.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":63.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":12.16,"standard_charge_algorithm": "Lesser of $12.16 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":11.92,"standard_charge_algorithm": "Lesser of $11.92 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VANC PEAK","code_information":[{"code":"80202","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":108.77,"maximum":143.04,"gross_charge":149,"discounted_cash":86.42,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":141.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":143.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":123.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.77,"methodology":"fee schedule"}]}]},{"description":"VANC PEAK","code_information":[{"code":"80202","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.54,"maximum":143.04,"gross_charge":149,"discounted_cash":86.42,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":141.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":143.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.77,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":123.67,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.77,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.81,"standard_charge_algorithm": "Lesser of $13.81 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.54,"standard_charge_algorithm": "Lesser of $13.54 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ZONISAMIDE","code_information":[{"code":"80203","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":118.99,"maximum":156.48,"gross_charge":163,"discounted_cash":94.54,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":154.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":156.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":118.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":135.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":118.99,"methodology":"fee schedule"}]}]},{"description":"ZONISAMIDE","code_information":[{"code":"80203","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.25,"maximum":156.48,"gross_charge":163,"discounted_cash":94.54,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":154.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":156.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":118.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":135.29,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":118.99,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":78.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.52,"standard_charge_algorithm": "Lesser of $13.52 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.25,"standard_charge_algorithm": "Lesser of $13.25 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ZONISAMIDE (ZONEGRAN)","code_information":[{"code":"80203","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":29.02,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"}]}]},{"description":"ZONISAMIDE (ZONEGRAN)","code_information":[{"code":"80203","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":13.25,"maximum":38.16,"gross_charge":39.75,"discounted_cash":23.06,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":37.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":38.16,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":33,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":29.02,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":19.08,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.52,"standard_charge_algorithm": "Lesser of $13.52 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":13.25,"standard_charge_algorithm": "Lesser of $13.25 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"HYDROXYCHLOROQUINE","code_information":[{"code":"80220","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":40.83,"maximum":53.69,"gross_charge":55.92,"discounted_cash":32.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":53.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":53.69,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.83,"methodology":"fee schedule"}]}]},{"description":"HYDROXYCHLOROQUINE","code_information":[{"code":"80220","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":17.9,"maximum":53.69,"gross_charge":55.92,"discounted_cash":32.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":53.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":53.69,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":17.9,"methodology":"fee schedule"}]}]},{"description":"INFLIXIMAB DRUG LEVEL","code_information":[{"code":"80230","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":154.76,"maximum":203.52,"gross_charge":212,"discounted_cash":122.96,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":201.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":203.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":154.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":175.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":154.76,"methodology":"fee schedule"}]}]},{"description":"INFLIXIMAB DRUG LEVEL","code_information":[{"code":"80230","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":38.57,"maximum":203.52,"gross_charge":212,"discounted_cash":122.96,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":201.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":203.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":154.76,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":175.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":154.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":101.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":39.34,"standard_charge_algorithm": "Lesser of $39.34 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":38.57,"standard_charge_algorithm": "Lesser of $38.57 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"LACOSAMIDE","code_information":[{"code":"80235","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":116.8,"maximum":153.6,"gross_charge":160,"discounted_cash":92.8,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":152,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":153.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":132.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.8,"methodology":"fee schedule"}]}]},{"description":"LACOSAMIDE","code_information":[{"code":"80235","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":27.11,"maximum":153.6,"gross_charge":160,"discounted_cash":92.8,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":152,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":153.6,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":116.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":132.8,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":116.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":76.8,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":27.65,"standard_charge_algorithm": "Lesser of $27.65 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":27.11,"standard_charge_algorithm": "Lesser of $27.11 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"LACOSAMIDE S/P","code_information":[{"code":"80235","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":59.38,"maximum":78.08,"gross_charge":81.33,"discounted_cash":47.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":77.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":78.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":59.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":59.38,"methodology":"fee schedule"}]}]},{"description":"LACOSAMIDE S/P","code_information":[{"code":"80235","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":27.11,"maximum":78.08,"gross_charge":81.33,"discounted_cash":47.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":77.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":78.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":59.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":59.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":27.65,"standard_charge_algorithm": "Lesser of $27.65 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":27.11,"standard_charge_algorithm": "Lesser of $27.11 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VEDOLIZUMAB","code_information":[{"code":"80280","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":396.39,"maximum":521.28,"gross_charge":543,"discounted_cash":314.94,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":515.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":521.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":396.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":450.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":396.39,"methodology":"fee schedule"}]}]},{"description":"VEDOLIZUMAB","code_information":[{"code":"80280","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":38.57,"maximum":521.28,"gross_charge":543,"discounted_cash":314.94,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":515.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":521.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":396.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":450.69,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":396.39,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":260.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":39.34,"standard_charge_algorithm": "Lesser of $39.34 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":38.57,"standard_charge_algorithm": "Lesser of $38.57 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VEDOLIZUMAB QUANT","code_information":[{"code":"80280","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":311.71,"maximum":409.92,"gross_charge":427,"discounted_cash":247.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":405.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":409.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":311.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":354.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":311.71,"methodology":"fee schedule"}]}]},{"description":"VEDOLIZUMAB QUANT","code_information":[{"code":"80280","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":38.57,"maximum":409.92,"gross_charge":427,"discounted_cash":247.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":405.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":409.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":311.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":354.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":311.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":204.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":39.34,"standard_charge_algorithm": "Lesser of $39.34 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":38.57,"standard_charge_algorithm": "Lesser of $38.57 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"VORICONAZOLE","code_information":[{"code":"80285","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":59.38,"maximum":78.08,"gross_charge":81.33,"discounted_cash":47.18,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":77.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":78.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":59.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":59.38,"methodology":"fee schedule"}]}]},{"description":"VORICONAZOLE","code_information":[{"code":"80285","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":27.11,"maximum":78.08,"gross_charge":81.33,"discounted_cash":47.18,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":77.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":78.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":59.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":67.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":59.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":39.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":27.65,"standard_charge_algorithm": "Lesser of $27.65 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":27.11,"standard_charge_algorithm": "Lesser of $27.11 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CERTOLIZUMAB","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":144.54,"maximum":190.08,"gross_charge":198,"discounted_cash":114.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":188.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":190.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":164.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":144.54,"methodology":"fee schedule"}]}]},{"description":"CERTOLIZUMAB","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":190.08,"gross_charge":198,"discounted_cash":114.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":188.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":190.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":164.34,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":144.54,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":95.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"CLONAZEPAM","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":90.52,"maximum":119.04,"gross_charge":124,"discounted_cash":71.92,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":117.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":102.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":90.52,"methodology":"fee schedule"}]}]},{"description":"CLONAZEPAM","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":119.04,"gross_charge":124,"discounted_cash":71.92,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":117.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":119.04,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":102.92,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":90.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":59.52,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"DEXAMETHASONE","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":122.64,"maximum":161.28,"gross_charge":168,"discounted_cash":97.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":159.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":161.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":122.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":139.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":122.64,"methodology":"fee schedule"}]}]},{"description":"DEXAMETHASONE","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":161.28,"gross_charge":168,"discounted_cash":97.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":159.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":161.28,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":122.64,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":139.44,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":122.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":80.64,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"DEXAMETHASONE S/P LC-MS/MS","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":40.83,"maximum":53.69,"gross_charge":55.92,"discounted_cash":32.44,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":53.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":53.69,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.83,"methodology":"fee schedule"}]}]},{"description":"DEXAMETHASONE S/P LC-MS/MS","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":53.69,"gross_charge":55.92,"discounted_cash":32.44,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":53.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":53.69,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":46.42,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":40.83,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":26.85,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"DISOPYRAMIDE","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":58.4,"maximum":76.8,"gross_charge":80,"discounted_cash":46.4,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":76.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":58.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":66.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":58.4,"methodology":"fee schedule"}]}]},{"description":"DISOPYRAMIDE","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":76.8,"gross_charge":80,"discounted_cash":46.4,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":76,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":76.8,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":58.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":66.4,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":58.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":38.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"USTEKINUMAB","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":139.43,"maximum":183.36,"gross_charge":191,"discounted_cash":110.78,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":181.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":183.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":139.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":158.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":139.43,"methodology":"fee schedule"}]}]},{"description":"USTEKINUMAB","code_information":[{"code":"80299","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":18.64,"maximum":183.36,"gross_charge":191,"discounted_cash":110.78,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":181.45,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":183.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":139.43,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":158.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":139.43,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":91.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":19.01,"standard_charge_algorithm": "Lesser of $19.01 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":18.64,"standard_charge_algorithm": "Lesser of $18.64 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ALCOHOL SERUM","code_information":[{"code":"80307","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":135.78,"maximum":178.56,"gross_charge":186,"discounted_cash":107.88,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":176.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":178.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":154.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":135.78,"methodology":"fee schedule"}]}]},{"description":"ALCOHOL SERUM","code_information":[{"code":"80307","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":62.14,"maximum":178.56,"gross_charge":186,"discounted_cash":107.88,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":176.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":178.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":135.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":154.38,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":135.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":89.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":63.38,"standard_charge_algorithm": "Lesser of $63.38 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":62.14,"standard_charge_algorithm": "Lesser of $62.14 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"DRUG SCREEN URINE (NPL)","code_information":[{"code":"80307","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":632.18,"maximum":831.36,"gross_charge":866,"discounted_cash":502.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":822.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":831.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":632.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":718.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":632.18,"methodology":"fee schedule"}]}]},{"description":"DRUG SCREEN URINE (NPL)","code_information":[{"code":"80307","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":62.14,"maximum":831.36,"gross_charge":866,"discounted_cash":502.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":822.7,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":831.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":632.18,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":718.78,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":632.18,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":415.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":63.38,"standard_charge_algorithm": "Lesser of $63.38 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":62.14,"standard_charge_algorithm": "Lesser of $62.14 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"DRUGS OF ABUSE 9 PANEL S OR P","code_information":[{"code":"80307","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":136.09,"maximum":178.97,"gross_charge":186.42,"discounted_cash":108.13,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":177.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":178.97,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":136.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":154.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":136.09,"methodology":"fee schedule"}]}]},{"description":"DRUGS OF ABUSE 9 PANEL S OR P","code_information":[{"code":"80307","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":62.14,"maximum":178.97,"gross_charge":186.42,"discounted_cash":108.13,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":177.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":178.97,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":136.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":154.73,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":136.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":89.49,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":63.38,"standard_charge_algorithm": "Lesser of $63.38 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":62.14,"standard_charge_algorithm": "Lesser of $62.14 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"ETOH BLD","code_information":[{"code":"80307","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":435.81,"maximum":573.12,"gross_charge":597,"discounted_cash":346.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":567.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":573.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":495.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.81,"methodology":"fee schedule"}]}]},{"description":"ETOH BLD","code_information":[{"code":"80307","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":62.14,"maximum":573.12,"gross_charge":597,"discounted_cash":346.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":567.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":573.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":495.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":63.38,"standard_charge_algorithm": "Lesser of $63.38 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":62.14,"standard_charge_algorithm": "Lesser of $62.14 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"FLUNITRAZEPAM S/P","code_information":[{"code":"80307","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":119.72,"maximum":157.44,"gross_charge":164,"discounted_cash":95.12,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":155.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":157.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":119.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":136.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":119.72,"methodology":"fee schedule"}]}]},{"description":"FLUNITRAZEPAM S/P","code_information":[{"code":"80307","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":62.14,"maximum":157.44,"gross_charge":164,"discounted_cash":95.12,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":155.8,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":157.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":119.72,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":136.12,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":119.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":78.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":63.38,"standard_charge_algorithm": "Lesser of $63.38 or 102 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":62.14,"standard_charge_algorithm": "Lesser of $62.14 or 100 Percent of Billed Charges","count":"0","methodology":"fee schedule", "additional_payer_notes": "No services performed during 12-month lookback period."}]}]},{"description":"METHANOL","code_information":[{"code":"80320","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"METHANOL","code_information":[{"code":"80320","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"ETHYL GLUCURONIDE/SULFATE","code_information":[{"code":"80321","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":108.04,"maximum":142.08,"gross_charge":148,"discounted_cash":85.84,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":140.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.04,"methodology":"fee schedule"}]}]},{"description":"ETHYL GLUCURONIDE/SULFATE","code_information":[{"code":"80321","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":47.36,"maximum":142.08,"gross_charge":148,"discounted_cash":85.84,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":140.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":142.08,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":122.84,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":108.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":71.04,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":51.33,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":47.36,"methodology":"fee schedule"}]}]},{"description":"PHOSPHATIDYLETHANOL (PETH) WB","code_information":[{"code":"80321","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"PHOSPHATIDYLETHANOL (PETH) WB","code_information":[{"code":"80321","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"ALKALOIDS NOS","code_information":[{"code":"80323","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"ALKALOIDS NOS","code_information":[{"code":"80323","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"ALKALOIDS NOS MEC QUAL","code_information":[{"code":"80323","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":68.6,"maximum":90.21,"gross_charge":93.96,"discounted_cash":54.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":89.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":90.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":68.6,"methodology":"fee schedule"}]}]},{"description":"ALKALOIDS NOS MEC QUAL","code_information":[{"code":"80323","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":30.07,"maximum":90.21,"gross_charge":93.96,"discounted_cash":54.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":89.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":90.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":45.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":30.07,"methodology":"fee schedule"}]}]},{"description":"NICOTINE AND METABOLITE","code_information":[{"code":"80323","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":389.09,"maximum":511.68,"gross_charge":533,"discounted_cash":309.14,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":506.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":511.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":389.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":442.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":389.09,"methodology":"fee schedule"}]}]},{"description":"NICOTINE AND METABOLITE","code_information":[{"code":"80323","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":170.56,"maximum":511.68,"gross_charge":533,"discounted_cash":309.14,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":506.35,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":511.68,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":389.09,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":442.39,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":389.09,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":255.84,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":184.85,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":170.56,"methodology":"fee schedule"}]}]},{"description":"NICOTINE AND METABOLITES UR","code_information":[{"code":"80323","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":209.51,"maximum":275.52,"gross_charge":287,"discounted_cash":166.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":272.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":275.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":209.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":238.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":209.51,"methodology":"fee schedule"}]}]},{"description":"NICOTINE AND METABOLITES UR","code_information":[{"code":"80323","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":91.84,"maximum":275.52,"gross_charge":287,"discounted_cash":166.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":272.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":275.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":209.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":238.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":209.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":137.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":99.54,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":91.84,"methodology":"fee schedule"}]}]},{"description":"NICOTINE AND METS URN QUANT","code_information":[{"code":"80323","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"NICOTINE AND METS URN QUANT","code_information":[{"code":"80323","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINESS/PQNT","code_information":[{"code":"80324","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":125.31,"maximum":164.79,"gross_charge":171.65,"discounted_cash":99.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":163.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":164.79,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":125.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":142.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":125.31,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINESS/PQNT","code_information":[{"code":"80324","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":54.93,"maximum":164.79,"gross_charge":171.65,"discounted_cash":99.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":163.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":164.79,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":125.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":142.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":125.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":82.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":59.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":54.93,"methodology":"fee schedule"}]}]},{"description":"METHAMPHATAMINE CONFIRMATION","code_information":[{"code":"80324","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":110.96,"maximum":145.92,"gross_charge":152,"discounted_cash":88.16,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":144.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":145.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":110.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":110.96,"methodology":"fee schedule"}]}]},{"description":"METHAMPHATAMINE CONFIRMATION","code_information":[{"code":"80324","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":48.64,"maximum":145.92,"gross_charge":152,"discounted_cash":88.16,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":144.4,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":145.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":110.96,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":126.16,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":110.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":72.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":52.72,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":48.64,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINES 3OR 4","code_information":[{"code":"80325","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":435.25,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINES 3OR 4","code_information":[{"code":"80325","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":190.8,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":206.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":190.8,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINES URN SCREEN","code_information":[{"code":"80325","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINES URN SCREEN","code_information":[{"code":"80325","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINEURNQNT","code_information":[{"code":"80325","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":125.31,"maximum":164.79,"gross_charge":171.65,"discounted_cash":99.56,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":163.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":164.79,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":125.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":142.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":125.31,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINEURNQNT","code_information":[{"code":"80325","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":54.93,"maximum":164.79,"gross_charge":171.65,"discounted_cash":99.56,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":163.07,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":164.79,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":125.31,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":142.47,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":125.31,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":82.4,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":59.53,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":54.93,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINE MEC QUAL","code_information":[{"code":"80326","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":68.6,"maximum":90.21,"gross_charge":93.96,"discounted_cash":54.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":89.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":90.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":68.6,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINE MEC QUAL","code_information":[{"code":"80326","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":30.07,"maximum":90.21,"gross_charge":93.96,"discounted_cash":54.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":89.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":90.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":45.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":30.07,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINES 5 OR MORE","code_information":[{"code":"80326","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINES 5 OR MORE","code_information":[{"code":"80326","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINESCORDQUAL","code_information":[{"code":"80326","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":85.74,"maximum":112.76,"gross_charge":117.45,"discounted_cash":68.13,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":111.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":112.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":85.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":85.74,"methodology":"fee schedule"}]}]},{"description":"AMPHETAMINESCORDQUAL","code_information":[{"code":"80326","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":37.59,"maximum":112.76,"gross_charge":117.45,"discounted_cash":68.13,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":111.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":112.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":85.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":85.74,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":40.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":37.59,"methodology":"fee schedule"}]}]},{"description":"ANALGESICS NON-OPIOID 1 OR 2","code_information":[{"code":"80329","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"ANALGESICS NON-OPIOID 1 OR 2","code_information":[{"code":"80329","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"IBUPROFEN","code_information":[{"code":"80329","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":64.24,"maximum":84.48,"gross_charge":88,"discounted_cash":51.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":83.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":84.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":64.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":73.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":64.24,"methodology":"fee schedule"}]}]},{"description":"IBUPROFEN","code_information":[{"code":"80329","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":28.16,"maximum":84.48,"gross_charge":88,"discounted_cash":51.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":83.6,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":84.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":64.24,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":73.04,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":64.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":42.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":30.52,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":28.16,"methodology":"fee schedule"}]}]},{"description":"ANTIDEPRESSANTS CLASS 6/MORE","code_information":[{"code":"80334","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"ANTIDEPRESSANTS CLASS 6/MORE","code_information":[{"code":"80334","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"AMITRIPTYLINE & METABOLITE","code_information":[{"code":"80335","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":263.53,"maximum":346.56,"gross_charge":361,"discounted_cash":209.38,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":342.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":346.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":299.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":263.53,"methodology":"fee schedule"}]}]},{"description":"AMITRIPTYLINE & METABOLITE","code_information":[{"code":"80335","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":115.52,"maximum":346.56,"gross_charge":361,"discounted_cash":209.38,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":342.95,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":346.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":299.63,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":263.53,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":173.28,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":125.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":115.52,"methodology":"fee schedule"}]}]},{"description":"AMITRIPTYLINE & NORTRIPTYLINE","code_information":[{"code":"80335","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":255.5,"maximum":336,"gross_charge":350,"discounted_cash":203,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":336,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":255.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":290.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":255.5,"methodology":"fee schedule"}]}]},{"description":"AMITRIPTYLINE & NORTRIPTYLINE","code_information":[{"code":"80335","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":112,"maximum":336,"gross_charge":350,"discounted_cash":203,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":332.5,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":336,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":255.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":290.5,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":255.5,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":168,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":121.38,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":112,"methodology":"fee schedule"}]}]},{"description":"AMITRIPTYLINE NORTRIPTYLINESP","code_information":[{"code":"80335","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"AMITRIPTYLINE NORTRIPTYLINESP","code_information":[{"code":"80335","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"TRICYCLIC & CYCLICALS 6/MORE","code_information":[{"code":"80337","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"TRICYCLIC & CYCLICALS 6/MORE","code_information":[{"code":"80337","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"ANTIDEPRESSANT NOT SPECIFIED","code_information":[{"code":"80338","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"ANTIDEPRESSANT NOT SPECIFIED","code_information":[{"code":"80338","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"TRAZODONE","code_information":[{"code":"80338","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":165.71,"maximum":217.92,"gross_charge":227,"discounted_cash":131.66,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":215.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":188.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.71,"methodology":"fee schedule"}]}]},{"description":"TRAZODONE","code_information":[{"code":"80338","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":72.64,"maximum":217.92,"gross_charge":227,"discounted_cash":131.66,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":215.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":217.92,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":188.41,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":165.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":108.96,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":78.73,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":72.64,"methodology":"fee schedule"}]}]},{"description":"CLOBAZAM AND METABOLITEQNS/P","code_information":[{"code":"80339","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"CLOBAZAM AND METABOLITEQNS/P","code_information":[{"code":"80339","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"ANTIEPILEPTICS NOS 7/MORE","code_information":[{"code":"80341","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"ANTIEPILEPTICS NOS 7/MORE","code_information":[{"code":"80341","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"OLANZAPINE SERUM","code_information":[{"code":"80342","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":137.97,"maximum":181.44,"gross_charge":189,"discounted_cash":109.62,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":179.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":181.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":137.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":156.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":137.97,"methodology":"fee schedule"}]}]},{"description":"OLANZAPINE SERUM","code_information":[{"code":"80342","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":60.48,"maximum":181.44,"gross_charge":189,"discounted_cash":109.62,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":179.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":181.44,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":137.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":156.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":137.97,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":90.72,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":65.55,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":60.48,"methodology":"fee schedule"}]}]},{"description":"ANTIPSYCHOTICS NOS 7/MORE","code_information":[{"code":"80344","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"ANTIPSYCHOTICS NOS 7/MORE","code_information":[{"code":"80344","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"BARBITURATES","code_information":[{"code":"80345","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":435.25,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"}]}]},{"description":"BARBITURATES","code_information":[{"code":"80345","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":190.8,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":206.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":190.8,"methodology":"fee schedule"}]}]},{"description":"BARBITURATESS/PQNT","code_information":[{"code":"80345","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"BARBITURATESS/PQNT","code_information":[{"code":"80345","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZEPINES1-12","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZEPINES1-12","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZEPINES1-12","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":435.25,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZEPINES1-12","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":190.8,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":206.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":190.8,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZEPINES1-12 RFLX","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.6,"maximum":329.55,"gross_charge":343.28,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.55,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.6,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZEPINES1-12 RFLX","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.85,"maximum":329.55,"gross_charge":343.28,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.12,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.55,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.93,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.05,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.85,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZEPINESS/PQNT","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZEPINESS/PQNT","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"FLUNITRAZEPAM CONF","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":136.51,"maximum":179.52,"gross_charge":187,"discounted_cash":108.46,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":177.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":179.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":136.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":155.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":136.51,"methodology":"fee schedule"}]}]},{"description":"FLUNITRAZEPAM CONF","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":59.84,"maximum":179.52,"gross_charge":187,"discounted_cash":108.46,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":177.65,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":179.52,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":136.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":155.21,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":136.51,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":89.76,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":64.86,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":59.84,"methodology":"fee schedule"}]}]},{"description":"FLUNITRAZEPAM SERUM OR PLASMA","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":157.68,"maximum":207.36,"gross_charge":216,"discounted_cash":125.28,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":205.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":207.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":157.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":179.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":157.68,"methodology":"fee schedule"}]}]},{"description":"FLUNITRAZEPAM SERUM OR PLASMA","code_information":[{"code":"80346","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":69.12,"maximum":207.36,"gross_charge":216,"discounted_cash":125.28,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":205.2,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":207.36,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":157.68,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":179.28,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":157.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":103.68,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":74.91,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":69.12,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZAPINESCORDQUAL","code_information":[{"code":"80347","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":85.74,"maximum":112.76,"gross_charge":117.45,"discounted_cash":68.13,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":111.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":112.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":85.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":85.74,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZAPINESCORDQUAL","code_information":[{"code":"80347","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":37.59,"maximum":112.76,"gross_charge":117.45,"discounted_cash":68.13,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":111.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":112.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":85.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":85.74,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":56.38,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":40.74,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":37.59,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZEPINE MEC QUAL","code_information":[{"code":"80347","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":68.6,"maximum":90.21,"gross_charge":93.96,"discounted_cash":54.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":89.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":90.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":68.6,"methodology":"fee schedule"}]}]},{"description":"BENZODIAZEPINE MEC QUAL","code_information":[{"code":"80347","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":30.07,"maximum":90.21,"gross_charge":93.96,"discounted_cash":54.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":89.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":90.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":45.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":30.07,"methodology":"fee schedule"}]}]},{"description":"BUPRENORPHINE","code_information":[{"code":"80348","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":435.25,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"}]}]},{"description":"BUPRENORPHINE","code_information":[{"code":"80348","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":190.8,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":206.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":190.8,"methodology":"fee schedule"}]}]},{"description":"BUPRENORPHINES/PQNT","code_information":[{"code":"80348","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"BUPRENORPHINES/PQNT","code_information":[{"code":"80348","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"DRUG SCREENING BUPRENORPHINE","code_information":[{"code":"80348","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"DRUG SCREENING BUPRENORPHINE","code_information":[{"code":"80348","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"CANNABINOIDS (THC) CONFIRM","code_information":[{"code":"80349","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":143.81,"maximum":189.12,"gross_charge":197,"discounted_cash":114.26,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":187.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":189.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":143.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":143.81,"methodology":"fee schedule"}]}]},{"description":"CANNABINOIDS (THC) CONFIRM","code_information":[{"code":"80349","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":63.04,"maximum":189.12,"gross_charge":197,"discounted_cash":114.26,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":187.15,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":189.12,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":143.81,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":163.51,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":143.81,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":94.56,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":68.32,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":63.04,"methodology":"fee schedule"}]}]},{"description":"THC METABOLITES/PQNT","code_information":[{"code":"80349","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"THC METABOLITES/PQNT","code_information":[{"code":"80349","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"COCAINE","code_information":[{"code":"80353","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":435.25,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"}]}]},{"description":"COCAINE","code_information":[{"code":"80353","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":190.8,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":206.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":190.8,"methodology":"fee schedule"}]}]},{"description":"COCAINE METAB UR QNT","code_information":[{"code":"80353","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":27.74,"maximum":36.48,"gross_charge":38,"discounted_cash":22.04,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":36.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":36.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":27.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":27.74,"methodology":"fee schedule"}]}]},{"description":"COCAINE METAB UR QNT","code_information":[{"code":"80353","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":12.16,"maximum":36.48,"gross_charge":38,"discounted_cash":22.04,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":36.1,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":36.48,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":27.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":31.54,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":27.74,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":18.24,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":13.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":12.16,"methodology":"fee schedule"}]}]},{"description":"COCAINE METABOLITESS/PQNT","code_information":[{"code":"80353","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"COCAINE METABOLITESS/PQNT","code_information":[{"code":"80353","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"DRUG SCREENING COCAINE","code_information":[{"code":"80353","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"DRUG SCREENING COCAINE","code_information":[{"code":"80353","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"DRUG SCREENING FENTANYL","code_information":[{"code":"80354","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":19.32,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"}]}]},{"description":"DRUG SCREENING FENTANYL","code_information":[{"code":"80354","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":8.47,"maximum":25.41,"gross_charge":26.46,"discounted_cash":15.35,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":25.14,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":25.41,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":21.97,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":19.32,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":12.71,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":9.18,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":8.47,"methodology":"fee schedule"}]}]},{"description":"FENTANYL","code_information":[{"code":"80354","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":435.25,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"}]}]},{"description":"FENTANYL","code_information":[{"code":"80354","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":190.8,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":206.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":190.8,"methodology":"fee schedule"}]}]},{"description":"FENTANYL AND METAB URN QUANT","code_information":[{"code":"80354","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":250.61,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"}]}]},{"description":"FENTANYL AND METAB URN QUANT","code_information":[{"code":"80354","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":109.86,"maximum":329.56,"gross_charge":343.29,"discounted_cash":199.11,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":326.13,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":329.56,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":284.94,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":250.61,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":164.78,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":119.06,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":109.86,"methodology":"fee schedule"}]}]},{"description":"GABAPENTIN MEC QUAL","code_information":[{"code":"80355","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":68.6,"maximum":90.21,"gross_charge":93.96,"discounted_cash":54.5,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":89.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":90.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":68.6,"methodology":"fee schedule"}]}]},{"description":"GABAPENTIN MEC QUAL","code_information":[{"code":"80355","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":30.07,"maximum":90.21,"gross_charge":93.96,"discounted_cash":54.5,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":89.27,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":90.21,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":77.99,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":68.6,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":45.11,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":32.59,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":30.07,"methodology":"fee schedule"}]}]},{"description":"GABAPENTIN NON-BLOOD","code_information":[{"code":"80355","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":435.25,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"}]}]},{"description":"GABAPENTIN NON-BLOOD","code_information":[{"code":"80355","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":190.8,"maximum":572.38,"gross_charge":596.22,"discounted_cash":345.81,"setting":"outpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":566.41,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":572.38,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":494.87,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|New Business","standard_charge_dollar":435.25,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicaid|All Plans","standard_charge_dollar":286.19,"methodology":"fee schedule"},{"payer_name":"BCBS - ND","plan_name":"Medicare|All Plans","standard_charge_dollar":206.77,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Medicare|All Plans","standard_charge_dollar":190.8,"methodology":"fee schedule"}]}]},{"description":"GABAPENTINCORDQUAL","code_information":[{"code":"80355","type":"CPT"},{"code":"0300","type":"RC"}],"standard_charges":[{"minimum":85.74,"maximum":112.76,"gross_charge":117.45,"discounted_cash":68.13,"setting":"inpatient","payers_information":[{"payer_name":"Health Partners","plan_name":"Commercial|All Plans","standard_charge_dollar":111.58,"methodology":"fee schedule"},{"payer_name":"Medica","plan_name":"Commercial|All Plans","standard_charge_dollar":112.76,"methodology":"fee schedule"},{"payer_name":"Sanford Health Plan","plan_name":"Commercial|All Plans","standard_charge_dollar":85.74,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Commercial|All Other Plans","standard_charge_dollar":97.49,"methodology":"fee schedule"},{"payer_name":"United","plan_name":"Co