{"hospital_name":"Hospital Perea","last_updated_on":"2026-08-28","version":"3.0.0","location_name":["Hospital Perea"],"hospital_address":["15 Calle Dr. Basora, PO Box 170, MAYAGUEZ, PR 006804833"],"type_2_npi":["1821082918"],"license_information":{"license_number":"49 | PR","state":"PR"},"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.","attester_name":"Lcdo. Marco A. Reyes Concepcion","confirm_attestation":true},"standard_charge_information":[{"description":"Quantitative Assay Drug","code_information":[
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                 { "code": "19281", "type": "CPT" } ],"standard_charges":[{"minimum":25.0000,"maximum":378.5200,"gross_charge":209.0000,"setting":"both","payers_information":[{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":378.5200,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":378.5200,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":300.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":100.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":100.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":300.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":378.5200,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":388.5000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":388.5000,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":378.5200,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":189.2600,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":378.5200,"methodology":"fee schedule"}]}]},{"description":"Coll Venous Bld Venipuncture","code_information":[
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                 { "code": "82384", "type": "CPT" } ],"standard_charges":[{"minimum":8.5400,"maximum":127.0000,"gross_charge":126.0000,"setting":"outpatient","payers_information":[{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":55.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":27.4900,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":55.0000,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":25.2500,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":25.2500,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":8.5400,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":24.5300,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":40.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":68.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":34.4000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":25.2500,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":35.2800,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":25.2500,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":35.2800,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":127.0000,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":95.0000,"methodology":"fee schedule"}]}]},{"description":"Assay Of Ceruloplasmin","code_information":[
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                 { "code": "82435", "type": "CPT" } ],"standard_charges":[{"minimum":4.6000,"maximum":11.0000,"gross_charge":119.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":6.4200,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":11.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":6.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":4.6000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":6.0000,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":10.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":6.4000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":6.4000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":6.8400,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":6.5800,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":6.5100,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":6.4900,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":4.6000,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":4.6000,"methodology":"fee schedule"},{"payer_name":"Plan De Salud Menonita","plan_name":"Plan De Salud Menonita Commercial","standard_charge_dollar":5.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":6.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":4.6000,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":6.4900,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":4.6000,"methodology":"fee schedule"}]}]},{"description":"Assay Of Urine Chloride","code_information":[
                 { "code": "82436", "type": "CPT" } ],"standard_charges":[{"minimum":3.4600,"maximum":11.0000,"gross_charge":15.0000,"setting":"outpatient","payers_information":[{"payer_name":"ACAA","plan_name":"ACAA Commercial","standard_charge_dollar":5.0000,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":7.0200,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":11.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":5.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":5.7500,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":5.0000,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":10.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":8.8000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":8.8000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":7.4800,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":3.4600,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":7.1200,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":4.0000,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":5.7500,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":5.7500,"methodology":"fee schedule"},{"payer_name":"Plan De Salud Menonita","plan_name":"Plan De Salud Menonita Commercial","standard_charge_dollar":5.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":4.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":5.7500,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":4.0000,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":5.7500,"methodology":"fee schedule"}]}]},{"description":"Assay Other Fluid Chlorides","code_information":[
                 { "code": "82438", "type": "CPT" } ],"standard_charges":[{"minimum":3.4600,"maximum":11.0000,"gross_charge":13.0000,"setting":"outpatient","payers_information":[{"payer_name":"ACAA","plan_name":"ACAA Commercial","standard_charge_dollar":5.0000,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":6.8300,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":11.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":7.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":5.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":7.0000,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":10.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":6.6600,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":6.6600,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":7.2800,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":3.4600,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":6.9300,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":6.4900,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":5.0000,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":5.0000,"methodology":"fee schedule"},{"payer_name":"Plan De Salud Menonita","plan_name":"Plan De Salud Menonita Commercial","standard_charge_dollar":5.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":6.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":5.0000,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":6.4900,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":5.0000,"methodology":"fee schedule"}]}]},{"description":"Test For Chlorohydrocarbons","code_information":[
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                 { "code": "83721", "type": "CPT" } ],"standard_charges":[{"minimum":10.5000,"maximum":30.0000,"gross_charge":20.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":13.3300,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":10.5000,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":24.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":13.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":16.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":14.1900,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":13.5100,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":13.3300,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":11.7800,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":10.5000,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":10.5000,"methodology":"fee schedule"},{"payer_name":"Plan De Salud Menonita","plan_name":"Plan De Salud Menonita Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":10.5000,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":13.3300,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":10.5000,"methodology":"fee schedule"}]}]},{"description":"Assay Of Lrh Hormone","code_information":[
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                 { "code": "86870", "type": "CPT" } ],"standard_charges":[{"minimum":25.0000,"maximum":103.3300,"gross_charge":70.0000,"setting":"outpatient","payers_information":[{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":84.0000,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":84.0000,"methodology":"fee schedule"},{"payer_name":"Plan De Salud Menonita","plan_name":"Plan De Salud Menonita Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":52.1500,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":103.3300,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":84.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":103.3300,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":52.1500,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":50.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":50.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":70.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":70.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":84.0000,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":53.4900,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":70.0000,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":70.0000,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":50.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":50.0000,"methodology":"fee schedule"},{"payer_name":"ACAA","plan_name":"ACAA Commercial","standard_charge_dollar":40.0000,"methodology":"fee schedule"}]}]},{"description":"Coombs Test Direct","code_information":[
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                 { "code": "86885", "type": "CPT" } ],"standard_charges":[{"minimum":5.7200,"maximum":57.6000,"gross_charge":50.0000,"setting":"outpatient","payers_information":[{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":8.5200,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":5.7200,"methodology":"fee schedule"}]}]},{"description":"Blood Typing Serologic Abo","code_information":[
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                 { "code": "87116", "type": "CPT" } ],"standard_charges":[{"minimum":10.8000,"maximum":56.0000,"gross_charge":40.0000,"setting":"outpatient","payers_information":[{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":10.8000,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":10.8000,"methodology":"fee schedule"},{"payer_name":"Plan De Salud Menonita","plan_name":"Plan De Salud Menonita Commercial","standard_charge_dollar":11.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":15.3000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":16.0700,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":13.3400,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":21.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":10.8000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":56.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":14.7100,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":10.8000,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":21.0000,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":10.8000,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":20.0000,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":18.0000,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":15.1000,"methodology":"fee schedule"}]}]},{"description":"Culture Type Immunologic","code_information":[
                 { "code": "87147", "type": "CPT" } ],"standard_charges":[{"minimum":5.1800,"maximum":22.0000,"gross_charge":48.0000,"setting":"outpatient","payers_information":[{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":7.2300,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":6.3900,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":5.8200,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":10.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":5.1800,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":10.0000,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":5.1800,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":5.1800,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":7.0500,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":7.0500,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":8.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":5.1800,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":7.2300,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":5.1800,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":7.2300,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":22.0000,"methodology":"fee schedule"}]}]},{"description":"Culture Typing Added Method","code_information":[
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                 { "code": "87320", "type": "CPT" } ],"standard_charges":[{"minimum":12.2600,"maximum":52.2000,"gross_charge":25.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":12.2600,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":15.0000,"methodology":"fee schedule"}]}]},{"description":"Clostridium Ag Ia","code_information":[
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                 { "code": "87328", "type": "CPT" } ],"standard_charges":[{"minimum":12.2600,"maximum":60.0000,"gross_charge":84.0000,"setting":"outpatient","payers_information":[{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":12.2600,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":14.8000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":13.8200,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":55.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":55.0000,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":13.8200,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":13.8200,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":13.8200,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":45.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":13.8200,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"}]}]},{"description":"Giardia Ag Ia","code_information":[
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                 { "code": "87338", "type": "CPT" } ],"standard_charges":[{"minimum":10.0700,"maximum":23.0000,"gross_charge":112.0000,"setting":"outpatient","payers_information":[{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":14.3800,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":14.3800,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":20.3700,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":21.3900,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":23.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":17.7600,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":19.5900,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":19.5900,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":14.3800,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":14.3800,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":10.0700,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":10.0700,"methodology":"fee schedule"}]}]},{"description":"H Pylori Ag Ia","code_information":[
                 { "code": "87339", "type": "CPT" } ],"standard_charges":[{"minimum":12.2600,"maximum":30.0000,"gross_charge":30.0000,"setting":"outpatient","payers_information":[{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":16.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":16.0000,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":16.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":12.2600,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":16.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":16.0000,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":16.0000,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"}]}]},{"description":"Hepatitis B Surface Ag Ia","code_information":[
                 { "code": "87340", "type": "CPT" } ],"standard_charges":[{"minimum":10.3300,"maximum":55.0000,"gross_charge":20.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":14.4300,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":13.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":13.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":10.3300,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":33.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":14.0700,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":20.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":13.4900,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":12.7500,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":14.6300,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":15.3600,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":10.3300,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":13.4900,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":10.3300,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":10.3300,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":10.3300,"methodology":"fee schedule"},{"payer_name":"Plan De Salud Menonita","plan_name":"Plan De Salud Menonita Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"}]}]},{"description":"Hepatitis Be Ag Ia","code_information":[
                 { "code": "87350", "type": "CPT" } ],"standard_charges":[{"minimum":11.5300,"maximum":35.0000,"gross_charge":35.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":16.1000,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":11.5300,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":35.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":15.7000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":24.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":22.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":26.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":14.2300,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":16.3200,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":17.1400,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":11.5300,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":26.0000,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":11.5300,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":11.5300,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":11.5300,"methodology":"fee schedule"},{"payer_name":"Plan De Salud Menonita","plan_name":"Plan De Salud Menonita Commercial","standard_charge_dollar":28.0000,"methodology":"fee schedule"}]}]},{"description":"Hepatitis Delta Agent Ag Ia","code_information":[
                 { "code": "87380", "type": "CPT" } ],"standard_charges":[{"minimum":15.2500,"maximum":100.0000,"gross_charge":140.0000,"setting":"outpatient","payers_information":[{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":18.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":18.0000,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":18.3600,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":18.3600,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":39.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":22.3600,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":15.2500,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":18.3600,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":18.3600,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":20.2600,"methodology":"fee schedule"}]}]},{"description":"Histoplasma Capsul Ag Ia","code_information":[
                 { "code": "87385", "type": "CPT" } ],"standard_charges":[{"minimum":12.2600,"maximum":115.0000,"gross_charge":210.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":13.2500,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":13.2500,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":12.2600,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":14.8000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":13.2500,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":13.2500,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":13.2500,"methodology":"fee schedule"}]}]},{"description":"Hiv-1 Ag Ia","code_information":[
                 { "code": "87390", "type": "CPT" } ],"standard_charges":[{"minimum":19.8600,"maximum":120.0000,"gross_charge":150.0000,"setting":"outpatient","payers_information":[{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":24.0600,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":24.0600,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":19.8600,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":24.0600,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":24.0600,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":33.6000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":24.0300,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":24.0600,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":24.6500,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":24.0600,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":24.6500,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":39.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"}]}]},{"description":"Influenza A Ag If","code_information":[
                 { "code": "87400", "type": "CPT" } ],"standard_charges":[{"minimum":12.5300,"maximum":40.0000,"gross_charge":35.0000,"setting":"outpatient","payers_information":[{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":15.4300,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":16.2000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":14.8000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":14.1300,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":14.1300,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":14.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":14.1300,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":14.1300,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":14.1300,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"}]}]},{"description":"Resp Syncytial Virus Ag Ia","code_information":[
                 { "code": "87420", "type": "CPT" } ],"standard_charges":[{"minimum":13.9100,"maximum":37.0000,"gross_charge":120.0000,"setting":"outpatient","payers_information":[{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":13.9100,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":14.8000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":15.0000,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":13.9100,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":13.9100,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":37.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":13.9100,"methodology":"fee schedule"}]}]},{"description":"Rotavirus Ag Ia","code_information":[
                 { "code": "87425", "type": "CPT" } ],"standard_charges":[{"minimum":11.9800,"maximum":30.0000,"gross_charge":49.0000,"setting":"outpatient","payers_information":[{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":14.8000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":12.2600,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":15.2500,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":11.9800,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":15.2500,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":11.9800,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":11.9800,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":14.8300,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":26.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":11.9800,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":11.9800,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":15.2200,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":30.0000,"methodology":"fee schedule"}]}]},{"description":"Sarscov Coronavirus Ag Ia","code_information":[
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                 { "code": "88267", "type": "CPT" } ],"standard_charges":[{"minimum":188.5700,"maximum":565.0000,"gross_charge":612.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":251.1700,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":540.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":510.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":510.0000,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":565.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":244.8900,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":200.0000,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":188.5700,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":188.5700,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":251.1700,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":188.5700,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":221.9500,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":188.5700,"methodology":"fee schedule"}]}]},{"description":"Chromosome Analys Amniotic","code_information":[
                 { "code": "88269", "type": "CPT" } ],"standard_charges":[{"minimum":173.6000,"maximum":550.0000,"gross_charge":660.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":232.3800,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":234.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":550.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":550.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":226.5700,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":550.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":200.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":173.6600,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":232.3800,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":173.6600,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":205.3400,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":173.6600,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":173.6600,"methodology":"fee schedule"}]}]},{"description":"Cytogenetics Dna Probe","code_information":[
                 { "code": "88271", "type": "CPT" } ],"standard_charges":[{"minimum":21.4200,"maximum":460.0000,"gross_charge":552.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":25.2800,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":75.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":460.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":460.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Vital Health Manintenance Organization","standard_charge_dollar":21.4200,"methodology":"fee schedule"},{"payer_name":"Mapfre","plan_name":"Mapfre Life Commercial","standard_charge_dollar":64.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":24.6500,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":160.0000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":21.4200,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":21.4200,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Selective Commercial","standard_charge_dollar":25.6400,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Vital Health Manintenance Organization","standard_charge_dollar":26.9200,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple S Commercial","standard_charge_dollar":50.0000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":26.4400,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":21.4200,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":25.2800,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":21.4200,"methodology":"fee schedule"}]}]},{"description":"Cytogenetics 25-99","code_information":[
                 { "code": "88274", "type": "CPT" } ],"standard_charges":[{"minimum":42.3800,"maximum":800.0000,"gross_charge":58.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":48.6300,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":145.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":800.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":800.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":47.4200,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":45.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":42.3800,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":48.6300,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":42.3800,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":42.9800,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":42.3800,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":42.3800,"methodology":"fee schedule"}]}]},{"description":"Chromosome Karyotype Study","code_information":[
                 { "code": "88280", "type": "CPT" } ],"standard_charges":[{"minimum":33.4700,"maximum":60.0000,"gross_charge":72.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":35.0700,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":52.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":60.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":60.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":34.1900,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":46.4000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":34.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":33.4700,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":35.0700,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":33.4700,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":33.4700,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":33.4700,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":33.4700,"methodology":"fee schedule"}]}]},{"description":"Chromosome Banding Study","code_information":[
                 { "code": "88283", "type": "CPT" } ],"standard_charges":[{"minimum":68.6000,"maximum":550.0000,"gross_charge":660.0000,"setting":"outpatient","payers_information":[{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":73.0600,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":107.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":550.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":550.0000,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":71.2300,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":90.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":68.6000,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":73.0600,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":68.6000,"methodology":"fee schedule"},{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":84.6900,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":68.6000,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":68.6000,"methodology":"fee schedule"}]}]},{"description":"Chromosome Count Additional","code_information":[
                 { "code": "88285", "type": "CPT" } ],"standard_charges":[{"minimum":25.0000,"maximum":45.0000,"gross_charge":54.0000,"setting":"outpatient","payers_information":[{"payer_name":"Triple-s","plan_name":"Triple-s Advantage (tsa) Medicare Avantage","standard_charge_dollar":26.9100,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Capitado Commercial","standard_charge_dollar":45.0000,"methodology":"fee schedule"},{"payer_name":"First Medical","plan_name":"First Medical Commercial","standard_charge_dollar":45.0000,"methodology":"fee schedule"},{"payer_name":"PMC","plan_name":"PMC Medicare Avantage","standard_charge_dollar":26.9100,"methodology":"fee schedule"},{"payer_name":"MMM","plan_name":"MMM Medicare Avantage","standard_charge_dollar":26.9100,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS CLASSICARE Medicare Avantage","standard_charge_dollar":25.8800,"methodology":"fee schedule"},{"payer_name":"MCS","plan_name":"MCS REGULAR Commercial","standard_charge_dollar":35.2000,"methodology":"fee schedule"},{"payer_name":"Prossam","plan_name":"Prossam Commercial","standard_charge_dollar":25.0000,"methodology":"fee schedule"},{"payer_name":"Tricare","plan_name":"Tricare Commercial","standard_charge_dollar":26.9100,"methodology":"fee schedule"},{"payer_name":"Plan Bella Vista","plan_name":"Plan Bella Vista Commercial","standard_charge_dollar":26.5400,"methodology":"fee schedule"},{"payer_name":"Adm. De Veteranos","plan_name":"Adm. De Veteranos Commercial","standard_charge_dollar":26.9100,"methodology":"fee schedule"},{"payer_name":"Champva","plan_name":"Champva Commercial","standard_charge_dollar":26.5400,"methodology":"fee schedule"},{"payer_name":"CIGNA","plan_name":"CIGNA PREFERRED Commercial","standard_charge_dollar":29.0000,"methodology":"fee schedule"}]}]},{"description":"Cyto\/molecular Report","code_information":[
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