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                 { "code": "43760", "type": "HCPCS" } ],"standard_charges":[{"minimum":31.1500,"maximum":356.5700,"gross_charge":300.0000,"discounted_cash":300.0000,"setting":"outpatient","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":31.1500,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":292.5000,"methodology":"per diem"},{"payer_name":"TRIPLE S","plan_name":"TRIPLE S ADVANTAGE","standard_charge_dollar":31.1500,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":292.5000,"methodology":"per diem"},{"payer_name":"MMM","plan_name":"MMM","standard_charge_dollar":31.1500,"methodology":"per diem"},{"payer_name":"MEDICARE","plan_name":"MEDICARE B","standard_charge_dollar":356.5700,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":31.1500,"methodology":"per diem"}]}]},{"description":"Tc-99m Sestamibi Up To 40 Mci","code_information":[
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                 { "code": "A9510", "type": "HCPCS" } ],"standard_charges":[{"minimum":60.8300,"maximum":70.0000,"gross_charge":50.2700,"discounted_cash":50.2700,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":70.0000,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":70.0000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":60.8300,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":60.8300,"methodology":"per diem"}]}]},{"description":"Tc-99m Pertechnetate Per Mci","code_information":[
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                 { "code": "A9515", "type": "HCPCS" } ],"standard_charges":[{"minimum":5130.0000,"maximum":5130.0000,"gross_charge":1.0000,"discounted_cash":1.0000,"setting":"both","payers_information":[{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":5130.0000,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":5130.0000,"methodology":"per diem"}]}]},{"description":"I-131 Capsule(S) Per Mci","code_information":[
                 { "code": "A9517", "type": "HCPCS" } ],"standard_charges":[{"minimum":11.3800,"maximum":40.7000,"gross_charge":40.7000,"discounted_cash":40.7000,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":35.0000,"methodology":"per diem"},{"payer_name":"INTERNATIONAL MEDICAL CARD","plan_name":"INTERNATIONAL MEDICAL CARD","standard_charge_dollar":12.0000,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":35.0000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":40.7000,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":11.3800,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":11.3800,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S COM","standard_charge_dollar":11.3800,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":40.7000,"methodology":"per diem"},{"payer_name":"MMM","plan_name":"MMM","standard_charge_dollar":40.7000,"methodology":"per diem"}]}]},{"description":"Tc-99 Tilmanoce Up To 0.5 Mci","code_information":[
                 { "code": "A9520", "type": "HCPCS" } ],"standard_charges":[{"minimum":455.0000,"maximum":535.4200,"gross_charge":2672.5500,"discounted_cash":2672.5500,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":455.0000,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":455.0000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":535.4200,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":535.4200,"methodology":"per diem"}]}]},{"description":"Tc-99m Exametazin Up To 25 Mci","code_information":[
                 { "code": "A9521", "type": "HCPCS" } ],"standard_charges":[{"minimum":1415.0000,"maximum":1742.8000,"gross_charge":1659.8100,"discounted_cash":1659.8100,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":1415.0000,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":1415.0000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":1742.8000,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":1742.8000,"methodology":"per diem"}]}]},{"description":"I-131 Iodina Ser Alb Per 5 Mic","code_information":[
                 { "code": "A9524", "type": "HCPCS" } ],"standard_charges":[{"minimum":61.7500,"maximum":90.2500,"gross_charge":61.7500,"discounted_cash":61.7500,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":90.2500,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":90.2500,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":61.7500,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":61.7500,"methodology":"per diem"}]}]},{"description":"I-131 Sod Iodide Caps Per Mci","code_information":[
                 { "code": "A9528", "type": "HCPCS" } ],"standard_charges":[{"minimum":49.5000,"maximum":113.8500,"gross_charge":113.8500,"discounted_cash":113.8500,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":49.5000,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":49.5000,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":113.8500,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":113.8500,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S COM","standard_charge_dollar":113.8500,"methodology":"per diem"}]}]},{"description":"I-131 Sod Iodide  Per Mci","code_information":[
                 { "code": "A9529", "type": "HCPCS" } ],"standard_charges":[{"minimum":31.0000,"maximum":31.0000,"gross_charge":1.0000,"discounted_cash":1.0000,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":31.0000,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":31.0000,"methodology":"per diem"}]}]},{"description":"I-131 Sod Iodide  Ther Per Mci","code_information":[
                 { "code": "A9530", "type": "HCPCS" } ],"standard_charges":[{"minimum":31.0000,"maximum":31.0000,"gross_charge":1.0000,"discounted_cash":1.0000,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":31.0000,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":31.0000,"methodology":"per diem"}]}]},{"description":"I-131 Sod Iodide Up To 100 Mic","code_information":[
                 { "code": "A9531", "type": "HCPCS" } ],"standard_charges":[{"minimum":30.0000,"maximum":30.0000,"gross_charge":1.0000,"discounted_cash":1.0000,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":30.0000,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":30.0000,"methodology":"per diem"}]}]},{"description":"Tc-99m Depreotide Up To 35 Mci","code_information":[
                 { "code": "A9536", "type": "HCPCS" } ],"standard_charges":[{"minimum":786.0000,"maximum":786.0000,"gross_charge":1.0000,"discounted_cash":1.0000,"setting":"both","payers_information":[{"payer_name":"INTERNATIONAL MEDICAL CARD","plan_name":"INTERNATIONAL MEDICAL CARD","standard_charge_dollar":786.0000,"methodology":"per diem"}]}]},{"description":"Tc-99m Mebrofenin Up To 15 Mci","code_information":[
                 { "code": "A9537", "type": "HCPCS" } ],"standard_charges":[{"minimum":31.5000,"maximum":50.0000,"gross_charge":63.0600,"discounted_cash":63.0600,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":50.0000,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":50.0000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":36.7800,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"MMM VITAL","standard_charge_dollar":31.5000,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":33.0700,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":33.0700,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S COM","standard_charge_dollar":33.0700,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":36.7800,"methodology":"per diem"}]}]},{"description":"Tc-99m Pyrophosph Up To 25 Mci","code_information":[
                 { "code": "A9538", "type": "HCPCS" } ],"standard_charges":[{"minimum":41.0000,"maximum":55.0000,"gross_charge":20.0300,"discounted_cash":20.0300,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":41.0000,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":41.0000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":55.0000,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":55.0000,"methodology":"per diem"}]}]},{"description":"Tc-99m Pentetate Up To 25 Mci","code_information":[
                 { "code": "A9539", "type": "HCPCS" } ],"standard_charges":[{"minimum":11.3600,"maximum":126.5600,"gross_charge":79.6200,"discounted_cash":79.6200,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":33.8500,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":33.8500,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":126.5600,"methodology":"per diem"},{"payer_name":"MENONITA COMERCIAL","plan_name":"MENONITA COMERCIAL","standard_charge_dollar":30.0000,"methodology":"per diem"},{"payer_name":"TRIPLE S","plan_name":"TRIPLE S ADVANTAGE","standard_charge_dollar":11.3600,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":28.0800,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":26.7400,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S COM","standard_charge_dollar":26.7400,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":126.5600,"methodology":"per diem"},{"payer_name":"MMM","plan_name":"MMM","standard_charge_dollar":43.3900,"methodology":"per diem"}]}]},{"description":"Tc-99m Maa Albumi Up To 10 Mci","code_information":[
                 { "code": "A9540", "type": "HCPCS" } ],"standard_charges":[{"minimum":23.7500,"maximum":227.8000,"gross_charge":165.0000,"discounted_cash":165.0000,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":23.7500,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":23.7500,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":227.8000,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":227.8000,"methodology":"per diem"},{"payer_name":"MMM","plan_name":"MMM","standard_charge_dollar":209.6400,"methodology":"per diem"}]}]},{"description":"Tc-99m Sulf Collo Up To 20 Mci","code_information":[
                 { "code": "A9541", "type": "HCPCS" } ],"standard_charges":[{"minimum":54.5000,"maximum":62.0200,"gross_charge":75.2200,"discounted_cash":75.2200,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":54.5000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":62.0200,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":54.5000,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":62.0200,"methodology":"per diem"},{"payer_name":"MMM","plan_name":"MMM","standard_charge_dollar":61.3000,"methodology":"per diem"}]}]},{"description":"Y-90 Ibritu Tiu Up To 40 Mci","code_information":[
                 { "code": "A9543", "type": "HCPCS" } ],"standard_charges":[{"minimum":51827.7700,"maximum":51827.7700,"gross_charge":51827.7700,"discounted_cash":51827.7700,"setting":"both","payers_information":[{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":51827.7700,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":51827.7700,"methodology":"per diem"}]}]},{"description":"In- 111 Oxyquinoli Per 0.5 Mci","code_information":[
                 { "code": "A9547", "type": "HCPCS" } ],"standard_charges":[{"minimum":212.5000,"maximum":2211.7300,"gross_charge":4076.9300,"discounted_cash":4076.9300,"setting":"both","payers_information":[{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":2211.7300,"methodology":"per diem"},{"payer_name":"TRIPLE S","plan_name":"TRIPLE S ADVANTAGE","standard_charge_dollar":212.5000,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":2211.7300,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S COM","standard_charge_dollar":500.0000,"methodology":"per diem"}]}]},{"description":"In- 111 Pentetate Per 0.5 Mci","code_information":[
                 { "code": "A9548", "type": "HCPCS" } ],"standard_charges":[{"minimum":407.0900,"maximum":1005.7600,"gross_charge":957.8700,"discounted_cash":957.8700,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":425.0000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":890.1900,"methodology":"per diem"},{"payer_name":"TRIPLE S","plan_name":"TRIPLE S ADVANTAGE","standard_charge_dollar":407.0900,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":1005.7600,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":957.8700,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S COM","standard_charge_dollar":957.8700,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":425.0000,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":890.1900,"methodology":"per diem"}]}]},{"description":"Tc-99m Succimer Up To 10 Mci","code_information":[
                 { "code": "A9551", "type": "HCPCS" } ],"standard_charges":[{"minimum":34.8500,"maximum":234.5600,"gross_charge":223.3900,"discounted_cash":223.3900,"setting":"both","payers_information":[{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":34.8500,"methodology":"per diem"},{"payer_name":"TRIPLE S","plan_name":"TRIPLE S ADVANTAGE","standard_charge_dollar":94.9400,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":234.5600,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":223.3900,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S COM","standard_charge_dollar":223.3900,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":34.8500,"methodology":"per diem"}]}]},{"description":"F-18 Fdg Up To 45 Mci","code_information":[
                 { "code": "A9552", "type": "HCPCS" } ],"standard_charges":[{"minimum":500.0000,"maximum":503.6100,"gross_charge":469.6800,"discounted_cash":469.6800,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":500.0000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":503.6100,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":500.0000,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":503.6100,"methodology":"per diem"}]}]},{"description":"I-125 Sod Iothala Up To 10 Mic","code_information":[
                 { "code": "A9554", "type": "HCPCS" } ],"standard_charges":[{"minimum":33.2500,"maximum":36.0000,"gross_charge":1.0000,"discounted_cash":1.0000,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":36.0000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":33.2500,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":36.0000,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":33.2500,"methodology":"per diem"}]}]},{"description":"Rubidium Rb-82 Up To 60 Mci","code_information":[
                 { "code": "A9555", "type": "HCPCS" } ],"standard_charges":[{"minimum":412.0600,"maximum":412.0600,"gross_charge":412.0600,"discounted_cash":412.0600,"setting":"both","payers_information":[{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":412.0600,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":412.0600,"methodology":"per diem"}]}]},{"description":"Gallium Ga-67 Citrate Per Mci","code_information":[
                 { "code": "A9556", "type": "HCPCS" } ],"standard_charges":[{"minimum":18.9000,"maximum":226.4200,"gross_charge":339.6300,"discounted_cash":339.6300,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":84.5000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":112.1600,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":112.1600,"methodology":"per diem"},{"payer_name":"TRIPLE S","plan_name":"TRIPLE S ADVANTAGE","standard_charge_dollar":226.4200,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":19.8500,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":18.9000,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S COM","standard_charge_dollar":18.9000,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":84.5000,"methodology":"per diem"},{"payer_name":"MMM","plan_name":"MMM","standard_charge_dollar":64.0500,"methodology":"per diem"}]}]},{"description":"Tc-99m Bicisate Up To 25 Mci","code_information":[
                 { "code": "A9557", "type": "HCPCS" } ],"standard_charges":[{"minimum":141.5000,"maximum":434.1200,"gross_charge":332.9300,"discounted_cash":332.9300,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":385.0000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":434.1200,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":434.1200,"methodology":"per diem"},{"payer_name":"TRIPLE S","plan_name":"TRIPLE S ADVANTAGE","standard_charge_dollar":141.5000,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":349.5800,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":332.9300,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S COM","standard_charge_dollar":332.9300,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":385.0000,"methodology":"per diem"}]}]},{"description":"Xenon Xe- 133 Gas Per 10 Mci","code_information":[
                 { "code": "A9558", "type": "HCPCS" } ],"standard_charges":[{"minimum":205.0000,"maximum":276.9600,"gross_charge":88.1300,"discounted_cash":88.1300,"setting":"both","payers_information":[{"payer_name":"HUMANA ADVANTAGE","plan_name":"HUMANA ADVANTAGE","standard_charge_dollar":205.0000,"methodology":"per diem"},{"payer_name":"MEDICAL CARD SYSTEM","plan_name":"MEDICAL CARD SYSTEM","standard_charge_dollar":276.9600,"methodology":"per diem"},{"payer_name":"MCS CLASSICARE","plan_name":"MCS CLASSICARE","standard_charge_dollar":276.9600,"methodology":"per diem"},{"payer_name":"HUMANA INSURANCE","plan_name":"HUMANA INSURANCE","standard_charge_dollar":205.0000,"methodology":"per diem"}]}]},{"description":"Tc-99m Oxidranate Up To 30 Mci","code_information":[
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                 { "code": "3000087", "type": "LOCAL" } ],"standard_charges":[{"minimum":3.8700,"maximum":6.0500,"gross_charge":17.5800,"discounted_cash":17.5800,"setting":"both","payers_information":[{"payer_name":"PLAN VITAL","plan_name":"MENONITA VITAL","standard_charge_dollar":6.0500,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":4.0700,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"MMM VITAL","standard_charge_dollar":3.8700,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":6.0500,"methodology":"per diem"}]}]},{"description":"Mononuclear Wbc Body Fluid","code_information":[
                 { "code": "3000106", "type": "LOCAL" } ],"standard_charges":[{"minimum":4.6900,"maximum":7.3300,"gross_charge":21.3000,"discounted_cash":21.3000,"setting":"both","payers_information":[{"payer_name":"PLAN VITAL","plan_name":"MENONITA VITAL","standard_charge_dollar":7.3300,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":4.9400,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"MMM VITAL","standard_charge_dollar":4.6900,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":7.3300,"methodology":"per diem"}]}]},{"description":"Occult Blood Body Fluid","code_information":[
                 { "code": "3000114", "type": "LOCAL" } ],"standard_charges":[{"minimum":14.4400,"maximum":22.5300,"gross_charge":65.4600,"discounted_cash":65.4600,"setting":"both","payers_information":[{"payer_name":"PLAN VITAL","plan_name":"MENONITA VITAL","standard_charge_dollar":22.5300,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":15.1700,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"MMM VITAL","standard_charge_dollar":14.4400,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":22.5300,"methodology":"per diem"}]}]},{"description":"Sodium Body Fluid","code_information":[
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                 { "code": "3000117", "type": "LOCAL" } ],"standard_charges":[{"minimum":3.9100,"maximum":6.0900,"gross_charge":17.7300,"discounted_cash":17.7300,"setting":"both","payers_information":[{"payer_name":"PLAN VITAL","plan_name":"MENONITA VITAL","standard_charge_dollar":6.0900,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":4.1000,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"MMM VITAL","standard_charge_dollar":3.9100,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":6.0900,"methodology":"per diem"}]}]},{"description":"Chloride Body Fluid","code_information":[
                 { "code": "3000118", "type": "LOCAL" } ],"standard_charges":[{"minimum":3.9000,"maximum":7.1200,"gross_charge":20.7000,"discounted_cash":20.7000,"setting":"both","payers_information":[{"payer_name":"PLAN VITAL","plan_name":"MENONITA VITAL","standard_charge_dollar":7.1200,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":3.9000,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"MMM VITAL","standard_charge_dollar":4.5700,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":7.1200,"methodology":"per diem"}]}]},{"description":"Albumin Body Fluid","code_information":[
                 { "code": "3000121", "type": "LOCAL" } ],"standard_charges":[{"minimum":3.9000,"maximum":7.3300,"gross_charge":21.3000,"discounted_cash":21.3000,"setting":"both","payers_information":[{"payer_name":"PLAN VITAL","plan_name":"MENONITA VITAL","standard_charge_dollar":7.3300,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":3.9000,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"MMM VITAL","standard_charge_dollar":5.7200,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":7.3300,"methodology":"per diem"}]}]},{"description":"Ldh Body Fluid","code_information":[
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                 { "code": "3000161", "type": "LOCAL" } ],"standard_charges":[{"minimum":3.3300,"maximum":5.1900,"gross_charge":15.0900,"discounted_cash":15.0900,"setting":"both","payers_information":[{"payer_name":"PLAN VITAL","plan_name":"FIRST MEDICAL VITAL","standard_charge_dollar":3.5000,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"MENONITA VITAL","standard_charge_dollar":5.1900,"methodology":"per diem"},{"payer_name":"PLAN VITAL","plan_name":"MMM VITAL","standard_charge_dollar":3.3300,"methodology":"per diem"},{"payer_name":"TRIPLE S COM","plan_name":"TRIPLE S VITAL","standard_charge_dollar":5.1900,"methodology":"per diem"}]}]},{"description":"Ldh Pericaridal Fluid","code_information":[
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