{
  "hospital_name": "Saint Luke’s Hospital of Kansas City",
  "last_updated_on": "2025-12-31",
  "version": "3.0.0",
  "location_name": ["Crittenton Children’s Center "],
  "hospital_address": [
    "10918 Elm Avenue, Kansas City MO 64134"
  ],
  "license_information": {
    "license_number": "87-9",
    "state": "MO"
  },
  "type_2_npi": ["282N00000X"],
  "attestation": {
    "attestation": "To the best of its knowledge and belief, this hospital has included all applicable standard charge information in accordance with the requirements of 45 CFR 180.50, and the information encoded is true, accurate, and complete as of the date in the file. This hospital has included all payer-specific negotiated charges in dollars that can be expressed as a dollar amount. For payer-specific negotiated charges that cannot be expressed as a dollar amount in the machine-readable file or not knowable in advance, the hospital attests that the payer-specific negotiated charge is based on a contractual algorithm, percentage or formula that precludes the provision of a dollar amount and has provided all necessary information available to the hospital for the public to be able to derive the dollar amount, including, but not limited to, the specific fee schedule or components referenced in such percentage, algorithm or formula.",
    "confirm_attestation": true,
    "attester_name": " Harold Mueller "
}
,
"standard_charge_information":[{"description":"ACAMPROSATE 333 MG TABLET DELAYED RELEASE","drug_information":{"unit":1.00,"type":"UN"},"code_information":[{"code":"00378-6333-80","type":"NDC"},{"code":"0250","type":"RC"},{"code":"0637","type":"RC"},{"code":"A9270","type":"HCPCS"},{"code":"RX-39720","type":"CDM"}],"standard_charges":[{"gross_charge":15.65,"discounted_cash":9.39,"minimum":3.91,"maximum":14.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":13.30,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":14.87,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":10.54,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":13.30,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":10.54,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":8.56,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":9.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":9.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.58,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":12.52,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.32,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":7.83,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.91,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":11.74,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":9.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":9.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":9.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":10.23,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.54,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":10.54,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"ACETAMINOPHEN 325 MG\/10.15 ML ORAL SUSPENSION","drug_information":{"unit":10.15,"type":"ML"},"code_information":[{"code":"0250","type":"RC"},{"code":"0637","type":"RC"},{"code":"68094-0330-59","type":"NDC"},{"code":"68094-0330-62","type":"NDC"},{"code":"A9270","type":"HCPCS"},{"code":"RX-88504","type":"CDM"}],"standard_charges":[{"gross_charge":18.70,"discounted_cash":11.22,"minimum":4.68,"maximum":18.70,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":12.53,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":11.18,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":12.53,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":11.65,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":11.18,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":12.53,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":12.53,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":12.16,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":12.16,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":12.16,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":11.44,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":12.16,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":9.22,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":13.09,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":14.96,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":6.36,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":9.35,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":18.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.68,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":14.03,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":18.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":11.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":11.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":11.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":11.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":11.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":12.22,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":5.42,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":18.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":18.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":18.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":18.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":12.59,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":18.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":18.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":18.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":18.90,"discounted_cash":11.34,"minimum":4.68,"maximum":18.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":16.07,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":17.96,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":12.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":16.07,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":12.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":12.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":12.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":12.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":10.34,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":11.77,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":11.77,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":12.66,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":11.77,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":11.87,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":10.00,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":12.66,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":11.30,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":12.66,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":11.77,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":11.30,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":12.66,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":12.66,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":12.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":12.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":12.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":11.57,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":12.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":9.32,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":13.23,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":15.12,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":6.43,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":9.45,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":18.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.73,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":14.18,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":18.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":11.20,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":11.20,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":11.20,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":11.20,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":11.20,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":12.35,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":5.48,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":18.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item 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posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":165.00,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":165.00,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":165.00,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":155.36,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":165.00,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":125.15,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":126.93,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":253.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":63.46,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":190.39,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":253.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":150.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":150.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":150.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":150.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":253.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":170.89,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":253.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":253.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":253.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"ALBUTEROL SULFATE HFA 90 MCG\/ACTUATION AEROSOL 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payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":132.28,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":167.03,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":132.28,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":107.52,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":122.42,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":122.42,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":103.95,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":131.66,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":117.51,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":131.66,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":122.42,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":117.51,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":131.66,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":131.66,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":127.73,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":127.73,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":127.73,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":120.26,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":127.73,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":96.87,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":137.55,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":196.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":49.13,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":147.38,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":196.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":116.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":116.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":116.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":116.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":116.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":128.45,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":56.99,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":10.05,"discounted_cash":6.03,"minimum":1.75,"maximum":9.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":8.54,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":6.77,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":6.77,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":6.77,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":6.77,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":5.50,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":6.26,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":6.26,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":6.73,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":6.26,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":6.31,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":5.32,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":6.73,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":6.01,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":6.73,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":6.26,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":6.01,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":6.73,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":6.73,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":6.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":6.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":6.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":6.15,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":6.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":4.95,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":7.04,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":8.04,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":3.42,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":5.03,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":10.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":2.51,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":7.54,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":10.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":5.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":5.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":5.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":5.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":5.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":6.57,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.91,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":10.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":10.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":2.50,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":2.36,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":2.50,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":1.90,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":2.70,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":3.08,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":1.31,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":1.93,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":3.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":0.96,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":2.89,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":3.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":3.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":3.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":2.59,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":3.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":3.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":3.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":8.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":8.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":8.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":8.05,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":8.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.48,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":9.21,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":10.52,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.47,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.58,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":13.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.29,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED 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[40018]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":4.40,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":3.70,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":21.65,"discounted_cash":12.99,"minimum":1.75,"maximum":20.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":18.40,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":20.57,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":14.57,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":18.40,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":14.57,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":14.57,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":14.57,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":14.57,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":11.85,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":13.49,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":13.49,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":11.45,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":14.51,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":12.95,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":14.51,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":13.49,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":12.95,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":14.51,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":14.51,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":14.07,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":14.07,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":14.07,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":13.25,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":14.07,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":10.67,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":15.16,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":17.32,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":7.36,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":10.83,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":21.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":5.41,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":16.24,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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[40018]","standard_charge_dollar":7.41,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":7.47,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":6.30,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":7.41,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":7.12,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":7.97,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":7.97,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":7.74,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":7.74,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":7.74,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":7.74,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":5.87,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.33,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":9.52,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.05,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":5.95,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":11.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":2.98,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":8.93,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":11.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.05,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.05,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.05,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":7.05,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":7.05,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":7.78,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":3.45,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":11.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":11.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":11.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":11.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.01,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":11.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":11.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":11.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":156.60,"discounted_cash":93.96,"minimum":1.75,"maximum":156.60,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":133.11,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":148.77,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":105.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":133.11,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":105.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":105.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":105.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":105.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":85.69,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":97.56,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":97.56,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":82.84,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":104.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":93.65,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":104.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":97.56,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":93.65,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":104.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":104.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":101.79,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":101.79,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":101.79,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":95.84,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":101.79,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":77.20,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":109.62,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":125.28,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":53.24,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":78.30,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":156.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":39.15,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":117.45,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":156.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":92.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":92.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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[4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":26.85,"discounted_cash":16.11,"minimum":1.75,"maximum":26.85,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":22.82,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":18.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":18.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":16.73,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":16.06,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":17.99,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":17.99,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":17.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":17.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":17.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":16.43,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":17.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":13.24,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":18.80,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":21.48,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":9.13,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":13.43,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":26.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":19.80,"discounted_cash":11.88,"minimum":1.75,"maximum":19.80,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":16.83,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":13.33,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":13.33,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":12.34,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":11.84,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":13.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":13.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":12.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":12.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":12.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":12.12,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":12.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":9.76,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":13.86,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":15.84,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":6.73,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":9.90,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":19.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.95,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":14.85,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":19.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":5.74,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":19.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":19.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":19.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":19.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":13.33,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":19.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":19.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":19.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":178.10,"discounted_cash":106.86,"minimum":1.75,"maximum":178.10,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":151.39,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":169.20,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":119.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":151.39,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":119.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":119.33,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":119.33,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":115.77,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":115.77,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":115.77,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":109.00,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":115.77,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":87.80,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":124.67,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":142.48,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":60.55,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":89.05,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":178.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":44.53,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":133.58,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":178.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":105.58,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":105.58,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":178.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":178.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":178.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":226.96,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":241.05,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":182.83,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":28.35,"discounted_cash":17.01,"minimum":1.75,"maximum":28.35,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":18.99,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":18.43,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":18.43,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":18.43,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":17.35,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":18.43,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":13.98,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":19.85,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":22.68,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":9.64,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":14.18,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":28.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.09,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":21.26,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":28.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":16.81,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":16.81,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":16.81,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":16.81,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":16.81,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":18.53,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":28.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":28.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":19.09,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":28.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":28.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":28.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[50005]","standard_charge_dollar":105.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":133.11,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":105.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":156.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":92.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":92.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":50.03,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":66.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":39.54,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":39.54,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":39.54,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":39.54,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":66.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":66.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":97.20,"discounted_cash":58.32,"minimum":16.68,"maximum":97.20,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":65.12,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":63.18,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":63.18,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":63.18,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":59.49,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":63.18,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":228.08,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":255.54,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":255.54,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":247.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":247.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":247.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":233.42,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":247.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":188.03,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":190.70,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":381.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":95.35,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":286.05,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":381.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":226.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":226.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":226.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":226.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":226.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":249.32,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":110.61,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":381.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":381.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":381.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":381.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":256.76,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":381.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":381.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":381.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":400.45,"discounted_cash":240.27,"minimum":16.68,"maximum":381.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":260.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":245.08,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":260.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":18.57,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":20.80,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":20.80,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":19.00,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":20.18,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":15.31,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":21.74,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":24.84,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":10.56,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":15.53,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":31.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.76,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":23.29,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":31.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":18.41,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":18.41,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":18.41,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":18.41,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":18.41,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":20.30,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":9.00,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":31.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":31.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":31.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":31.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":20.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":31.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":31.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":31.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":70.55,"discounted_cash":42.33,"minimum":7.76,"maximum":67.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":59.97,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":47.49,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":47.49,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":47.49,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":47.49,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":38.60,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":43.95,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":43.95,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":47.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":43.95,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":44.31,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":37.32,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":47.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":42.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":47.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":43.95,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":42.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":47.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":47.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":45.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":45.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":45.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":43.18,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":45.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":34.78,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":49.39,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":56.44,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":23.99,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":35.28,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":70.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":17.64,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":52.91,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":70.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":41.82,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":41.82,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":41.82,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":41.82,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":41.82,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":46.12,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":20.46,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":70.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":70.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":70.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":70.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":47.49,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":70.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":70.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":70.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":41.71,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":40.04,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":44.86,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":44.86,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":43.52,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":43.52,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":43.52,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":40.97,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":43.52,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":33.01,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":46.87,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":53.56,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":22.76,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":33.48,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":66.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":16.74,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":50.21,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":66.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":39.69,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":39.69,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":39.69,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":66.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":66.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":45.07,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":66.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":66.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":66.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":69.90,"discounted_cash":41.94,"minimum":7.76,"maximum":69.90,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":59.42,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":66.41,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":47.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":59.42,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":47.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":47.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":47.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":47.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":38.25,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":43.55,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":43.55,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":46.83,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":43.55,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":41.80,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":46.83,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":46.83,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":45.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":45.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":45.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":42.78,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":45.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":34.46,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":48.93,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":55.92,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":23.77,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":34.95,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":69.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":17.48,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":52.43,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":69.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":41.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":41.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":41.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":41.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":41.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":45.69,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":20.27,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":69.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":69.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":69.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":69.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":52.91,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":70.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":41.82,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":22.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":21.03,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":20.18,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":21.94,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":21.94,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":20.66,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":21.94,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":16.64,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":23.63,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":27.00,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":11.48,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":16.88,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":8.44,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":25.31,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":20.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":20.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":20.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":20.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":20.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":22.06,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":9.79,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":22.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":120.50,"discounted_cash":72.30,"minimum":8.44,"maximum":114.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":102.43,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":114.48,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":81.12,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":102.43,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":81.12,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":81.12,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":81.12,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":81.12,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":65.94,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":75.07,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":75.07,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":80.74,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":75.07,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":75.67,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":63.74,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":80.74,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":72.06,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":80.74,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":75.07,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":72.06,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":80.74,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":80.74,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":78.33,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":78.33,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":78.33,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":73.75,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":78.33,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":59.41,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":84.35,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":96.40,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":40.97,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":60.25,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":120.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":30.13,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":90.38,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":120.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":71.43,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":71.43,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":71.43,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":71.43,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":71.43,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":78.77,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":34.95,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":120.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":120.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":120.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":120.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":81.12,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed 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the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":24.83,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":33.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":19.62,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":22.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":20.18,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":22.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":21.03,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":20.18,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":22.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":22.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":21.94,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":21.94,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":21.94,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":20.66,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":21.94,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":16.64,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":23.63,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":27.00,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":11.48,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":16.88,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":8.44,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":25.31,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":20.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":20.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":20.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":20.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":20.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":22.06,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":9.79,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":22.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":33.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":76.65,"discounted_cash":45.99,"minimum":8.28,"maximum":76.65,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":65.15,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":72.82,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":51.60,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":65.15,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":51.60,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":51.60,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":51.60,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":51.60,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":41.94,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":47.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":47.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":40.55,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":51.36,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":45.84,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":51.36,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":47.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":45.84,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":51.36,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":51.36,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":49.82,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":49.82,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":49.82,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":46.91,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":49.82,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":37.79,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":53.66,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":61.32,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":26.06,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":38.33,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":76.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":19.16,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":57.49,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":76.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":45.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":45.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":45.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":45.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":45.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":50.11,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":22.23,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":76.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the 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15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":111.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":104.65,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":111.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":58.14,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":85.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":171.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":42.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":128.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":171.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":14.05,"discounted_cash":8.43,"minimum":1.75,"maximum":14.05,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":11.94,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":9.46,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":9.46,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":9.46,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":9.46,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":7.69,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":8.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":8.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":9.41,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE 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KS EXCHANGE HMO [40026]","standard_charge_dollar":9.41,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":8.40,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":9.41,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":8.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":8.40,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":9.41,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":9.41,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":9.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":9.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":9.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":8.60,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":9.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.93,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":9.84,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":11.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.78,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":7.03,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":14.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.51,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":10.54,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":14.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":8.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":8.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":8.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":8.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":8.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":9.18,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.07,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":14.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":14.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":14.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":14.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":9.46,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":14.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":14.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":14.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":26.85,"discounted_cash":16.11,"minimum":1.75,"maximum":26.85,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":22.82,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":25.51,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":18.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":22.82,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":18.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":17.99,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":16.73,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":16.06,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":17.99,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":17.99,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":17.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":17.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":17.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":16.43,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":17.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":13.24,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":18.80,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":21.48,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":9.13,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":13.43,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":26.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":6.71,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":20.14,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":26.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":15.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":15.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":15.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":15.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":15.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":17.55,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":7.79,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":26.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":26.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":26.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":26.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":18.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":26.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":26.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":962.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":570.75,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":570.75,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":119.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":119.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":115.64,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":142.32,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":60.49,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":88.95,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":177.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.86,"standard_charge_algorithm":"Fee schedule rate ($1.86).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":133.43,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":177.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":105.46,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":105.46,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":51.59,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":177.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":177.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":12.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":12.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":28.40,"discounted_cash":17.04,"minimum":3.19,"maximum":28.40,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":17.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":16.98,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":19.03,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":19.03,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":18.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":18.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":18.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":17.38,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":18.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":14.00,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":19.88,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":22.72,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":9.66,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":14.20,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.10,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":21.30,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":16.84,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":16.84,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":16.84,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":16.84,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":16.84,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":18.57,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":8.24,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":19.12,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":33.70,"discounted_cash":20.22,"minimum":3.19,"maximum":32.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":28.65,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":32.02,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":22.69,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":28.65,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":22.69,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":22.69,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":22.69,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":22.69,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":18.44,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":21.00,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":21.00,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":22.58,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":21.00,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":21.16,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":17.83,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":22.58,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":20.15,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":22.58,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":21.00,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":20.15,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":22.58,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":22.58,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":21.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":21.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":21.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":20.62,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":21.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":16.61,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":23.59,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":26.96,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":11.46,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":16.85,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":33.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":8.43,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":25.28,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":33.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":19.98,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":19.98,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":19.98,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":19.98,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":19.98,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":22.03,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":9.77,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":33.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":33.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":33.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":33.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":22.69,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":33.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":33.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":33.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"BUPROPION HCL 75 MG 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prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":10.86,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":11.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":8.75,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":12.43,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":14.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":6.04,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.88,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":17.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.44,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":13.31,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":17.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":10.52,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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[50014]","standard_charge_dollar":17.81,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":14.10,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":14.10,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":13.05,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":12.53,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":14.04,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":14.04,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":13.62,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":13.62,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":13.62,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":12.82,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":13.62,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":10.33,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":14.67,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":16.76,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":7.12,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":10.48,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":20.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":5.24,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":15.71,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":20.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":12.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":12.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":12.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":12.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":12.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":13.70,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":6.08,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":20.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":20.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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[4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":14.70,"discounted_cash":8.82,"minimum":1.75,"maximum":14.70,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":12.50,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":9.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":9.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":9.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":9.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":8.04,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL 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KS EXCHANGE HMO [40026]","standard_charge_dollar":9.85,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":8.79,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":9.85,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":9.16,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":8.79,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":9.85,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":9.85,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":9.56,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":9.56,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":9.56,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.00,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":9.56,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":7.25,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":10.29,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":11.76,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.00,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":7.35,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":14.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.68,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":11.03,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":14.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":8.71,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":8.71,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":8.71,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":8.71,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":8.71,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":9.61,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.26,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":14.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":14.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":14.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":14.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":9.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":12.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.19,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":7.63,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":15.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.81,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":11.44,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":15.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":9.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":9.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":15.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":15.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":15.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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KS EXCHANGE HMO [40026]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":11.70,"discounted_cash":7.02,"minimum":1.75,"maximum":11.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":9.95,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":11.12,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":7.88,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":9.95,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":7.88,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":7.88,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":7.88,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":7.88,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":6.40,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":7.29,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":7.29,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":7.84,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":7.29,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":7.35,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":6.19,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":7.84,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":7.00,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":7.84,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":7.29,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":7.00,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":7.84,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":7.84,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":7.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":7.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":7.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.16,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":7.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":5.77,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.19,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":9.36,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":3.98,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":5.85,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":11.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":2.93,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":8.78,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":11.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":6.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":6.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":6.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":6.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":6.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":7.65,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":3.39,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":11.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":11.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":11.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":11.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.00,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.00,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":14.90,"discounted_cash":8.94,"minimum":3.00,"maximum":14.90,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":12.67,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":10.03,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":10.03,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":9.98,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":9.69,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":9.69,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":9.69,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.12,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":9.69,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":7.35,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":10.43,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":11.92,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.07,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":7.45,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":14.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.73,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":11.18,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":14.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":8.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":8.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":8.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":8.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":8.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":9.74,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":14.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":14.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":10.03,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":14.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":14.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":14.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":39.50,"discounted_cash":23.70,"minimum":3.00,"maximum":39.50,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":33.58,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":37.53,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL 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[50010]","standard_charge_dollar":26.59,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":26.59,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":26.59,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":26.47,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":24.61,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":23.62,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":26.47,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":26.47,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":25.68,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":25.68,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":25.68,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":24.17,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":25.68,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":19.47,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":27.65,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":31.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":13.43,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":19.75,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":39.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":9.88,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":29.63,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":39.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":23.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":23.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":23.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":23.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":23.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":25.82,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":11.46,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":39.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":39.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":39.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":39.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":26.59,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":39.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":39.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":30.41,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":34.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":31.68,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":30.41,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":34.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":34.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":33.05,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":33.05,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":33.05,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":31.12,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":33.05,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":25.07,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":35.60,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":40.68,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":17.29,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":44.25,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":44.28,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":49.58,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":48.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":48.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":48.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":48.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":48.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":48.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":48.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":48.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":36.48,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":36.51,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":29.60,"standard_charge_percentage":40.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":29.62,"standard_charge_percentage":40.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":59.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":59.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":25.16,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":25.18,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":37.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":37.03,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":74.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":74.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.60,"standard_charge_algorithm":"Fee schedule rate ($3.60).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":55.50,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":55.54,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":74.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":74.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":43.87,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":43.90,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST 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file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":21.47,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":74.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":74.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":74.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":74.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":74.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":49.82,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":49.85,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET 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15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":48.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":48.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":48.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments 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the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":59.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":25.16,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":25.18,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":26.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":26.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":74.00,"discounted_cash":44.40,"minimum":1.72,"maximum":74.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":59.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":25.16,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":25.18,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":29.62,"standard_charge_percentage":40.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":59.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":59.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":25.16,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":25.18,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":37.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":21.46,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":21.47,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":74.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":27.06,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":30.32,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":30.32,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":29.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":22.31,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":18.10,"standard_charge_percentage":40.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":36.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":15.39,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":22.63,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":45.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.80,"standard_charge_algorithm":"Fee schedule rate ($1.80).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":33.94,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":45.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":26.82,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":26.82,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH 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file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":13.12,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":45.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":45.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":45.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":45.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":30.46,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":45.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":45.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":45.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments 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service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":30.50,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":30.50,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":24.79,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":28.22,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":28.22,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":30.35,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":30.35,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":27.09,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":30.35,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":28.22,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":27.09,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":30.35,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":30.35,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":29.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":29.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final 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posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":22.65,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":45.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.80,"standard_charge_algorithm":"Fee schedule rate ($1.80).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":33.98,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":45.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":26.85,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":37.15,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":42.30,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":42.30,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":35.92,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":45.49,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":40.60,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":45.49,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":42.30,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":40.60,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":44.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":44.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":44.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":67.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":67.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"CEPHALEXIN 250 MG 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CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"CHLORHEXIDINE GLUCONATE 0.12 % MOUTHWASH","drug_information":{"unit":15.00,"type":"ML"},"code_information":[{"code":"00116-2001-15","type":"NDC"},{"code":"0250","type":"RC"},{"code":"0637","type":"RC"},{"code":"69339-0138-15","type":"NDC"},{"code":"69339-0138-17","type":"NDC"},{"code":"A9270","type":"HCPCS"},{"code":"RX-9516","type":"CDM"}],"standard_charges":[{"gross_charge":33.45,"discounted_cash":20.07,"minimum":8.36,"maximum":33.45,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":28.43,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":31.78,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":22.52,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":28.43,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":22.52,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":22.52,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":22.52,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":22.52,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":18.30,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":20.84,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":20.84,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":22.41,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":20.84,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":21.01,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":17.70,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":22.41,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":20.00,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":22.41,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":20.84,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":20.00,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":22.41,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":22.41,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":21.74,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":21.74,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":21.74,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":20.47,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":21.74,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":16.49,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":23.42,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":26.76,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":11.37,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":16.73,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":33.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":8.36,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":25.09,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":33.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":19.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":19.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":19.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":19.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":19.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":21.87,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":9.70,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":33.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":33.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":33.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":33.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":18.53,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":17.23,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":16.53,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":18.53,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":18.53,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":17.97,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":17.97,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":17.97,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":16.92,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":17.97,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":13.63,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":19.36,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":22.12,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":9.40,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":13.83,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":27.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":6.91,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":20.74,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":27.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":16.39,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":16.39,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":16.39,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":16.39,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":16.39,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":18.07,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":8.02,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":27.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":27.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":27.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":27.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":18.61,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":27.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":27.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":27.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":84.25,"discounted_cash":50.55,"minimum":6.91,"maximum":80.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":71.61,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":80.04,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":56.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":71.61,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":56.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":56.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":56.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":56.72,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":46.10,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":52.49,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":52.49,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":56.45,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":52.49,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":50.38,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":56.45,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":52.49,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":50.38,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":56.45,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":56.45,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":54.76,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":54.76,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":54.76,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":51.56,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":54.76,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":41.54,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":58.98,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":67.40,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":28.65,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":42.13,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":84.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":21.06,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":63.19,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":84.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":49.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":49.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":49.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":49.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":49.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":55.07,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":24.43,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":8.60,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":10.89,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":9.72,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":10.89,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":10.89,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":10.56,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.56,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.56,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.95,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":10.56,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":8.01,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":11.38,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":13.00,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.53,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.13,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":16.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.06,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":12.19,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":16.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":9.63,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":9.63,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":10.62,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.71,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":16.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":16.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":16.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":16.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":10.94,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":16.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":16.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":16.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":42.65,"discounted_cash":25.59,"minimum":4.06,"maximum":42.65,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":36.25,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":40.52,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":28.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":36.25,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":28.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":28.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":28.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":28.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":23.34,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":26.57,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":26.57,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":28.58,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":26.57,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":26.78,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":22.56,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":28.58,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":25.50,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":28.58,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":26.57,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":25.50,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":28.58,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":28.58,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":27.72,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":27.72,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":27.72,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":26.10,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":27.72,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":21.03,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":29.86,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":34.12,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":14.50,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":21.33,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":42.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":10.66,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":31.99,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":42.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":25.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":25.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":25.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":25.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":14.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.58,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":10.73,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":589.49,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":589.49,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":589.49,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":555.02,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":589.49,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":447.10,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":453.45,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":906.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":226.73,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":680.18,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":906.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":537.61,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS 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BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":89.05,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":94.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":71.73,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":101.85,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":116.40,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":49.47,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":72.75,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":145.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":36.38,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":109.13,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":145.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":86.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":86.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":95.11,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":42.20,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":145.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":145.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":188.65,"discounted_cash":113.19,"minimum":36.38,"maximum":188.65,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":160.35,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":127.00,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":127.00,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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[4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":126.40,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":112.81,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":126.40,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":126.40,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":122.62,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":122.62,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":122.62,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":115.45,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":122.62,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":93.00,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":132.06,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":150.92,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":64.14,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":94.33,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":188.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":47.16,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":141.49,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":188.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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[4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":27.05,"discounted_cash":16.23,"minimum":1.75,"maximum":27.05,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":22.99,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":18.21,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":18.21,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":18.12,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":17.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":17.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":17.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":16.55,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":17.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":13.34,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":18.94,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":21.64,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":9.20,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":13.53,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":27.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":6.76,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":20.29,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":27.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":27.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":27.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":27.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":41.31,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":41.31,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":38.89,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":41.31,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":31.33,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":44.49,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":50.84,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":21.61,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":31.78,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":63.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":15.89,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":47.66,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":63.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":37.67,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":37.67,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":63.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":63.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":63.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":9.88,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":14.04,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":16.04,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":6.82,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":10.03,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":20.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":5.01,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":15.04,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":20.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":20.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":20.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":13.50,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":20.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":20.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":20.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA 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[5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"CYANOCOBALAMIN (VIT B-12) 500 MCG 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"CYPROHEPTADINE 4 MG TABLET","drug_information":{"unit":1.00,"type":"UN"},"code_information":[{"code":"0250","type":"RC"},{"code":"0637","type":"RC"},{"code":"50268-0189-11","type":"NDC"},{"code":"50268-0189-15","type":"NDC"},{"code":"50742-0190-01","type":"NDC"},{"code":"70710-1110-01","type":"NDC"},{"code":"A9270","type":"HCPCS"},{"code":"RX-2033","type":"CDM"}],"standard_charges":[{"gross_charge":7.00,"discounted_cash":4.20,"minimum":1.75,"maximum":7.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":5.95,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":6.65,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":5.95,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL 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[50000]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":3.83,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.14,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.72,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":9.96,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.23,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.23,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":12.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":12.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.38,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":36.57,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":38.84,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":29.46,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":29.88,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":59.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":14.94,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":44.81,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":59.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":35.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":84.62,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":106.85,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":84.62,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":81.71,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":81.71,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":76.93,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":125.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":31.43,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":94.28,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":125.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":74.51,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":74.51,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":35.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":35.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":35.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":35.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":23.56,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":35.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":35.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":35.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":42.40,"discounted_cash":25.44,"minimum":8.75,"maximum":42.40,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":27.56,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":25.95,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":27.56,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":20.90,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":29.68,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":33.92,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":14.42,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":21.20,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":42.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":10.60,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":31.80,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":42.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":25.13,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":25.13,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":25.13,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":42.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":42.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":42.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":51.29,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":47.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":45.78,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":51.29,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":51.29,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":49.76,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":49.76,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":49.76,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":46.85,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":49.76,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":37.74,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":53.59,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":61.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":26.03,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":38.28,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":76.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":19.14,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":57.41,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":76.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":45.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":45.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":45.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":45.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":45.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":50.04,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":22.20,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":76.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":76.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":76.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":76.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":51.53,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":76.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":76.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":76.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":82.75,"discounted_cash":49.65,"minimum":8.75,"maximum":78.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":70.34,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":78.61,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":55.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":70.34,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":55.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":55.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":55.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":55.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":45.28,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":51.55,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":51.55,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":55.44,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":51.55,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":49.48,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":55.44,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":51.55,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":49.48,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":55.44,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":55.44,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":53.79,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":53.79,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":53.79,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":50.64,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":53.79,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":40.80,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":57.93,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":66.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":28.14,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":41.38,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":82.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":20.69,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":62.06,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":82.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":49.05,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":49.05,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":49.05,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":49.05,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[40033]","standard_charge_dollar":27.41,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":29.48,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":27.41,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":26.31,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":29.48,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":29.48,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":28.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":28.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":28.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":26.93,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":28.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":21.69,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":30.80,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":35.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":14.96,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":22.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":44.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":11.00,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":33.00,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":44.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":26.08,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":26.08,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":26.08,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":26.08,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":26.08,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":28.76,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":12.76,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":44.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":44.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":44.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":44.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":29.62,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":44.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":44.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":44.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":74.50,"discounted_cash":44.70,"minimum":9.99,"maximum":70.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":63.33,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":50.15,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":50.15,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":50.15,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":50.15,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":40.77,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":46.41,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":46.41,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":49.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":49.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":44.55,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":49.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":46.41,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":44.55,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":49.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":49.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":48.43,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":48.43,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":48.43,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":45.59,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":48.43,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":36.73,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":52.15,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":59.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":25.33,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":37.25,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":74.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":18.63,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":55.88,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":74.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":44.16,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":44.16,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":44.16,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":6.76,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":7.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":7.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD 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BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":6.53,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":8.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":7.39,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":8.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":7.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":7.39,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":8.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":8.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":8.03,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":8.03,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":8.03,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.56,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":8.03,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.09,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.65,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":9.88,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.20,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.18,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.09,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.26,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":7.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":7.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":8.07,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":3.58,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.31,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":16.70,"discounted_cash":10.02,"minimum":3.09,"maximum":16.70,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":14.20,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":15.87,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":11.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":14.20,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":11.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":11.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":11.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":11.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":9.14,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":10.40,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":10.40,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":11.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":10.40,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":9.99,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":11.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":10.40,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":9.99,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":11.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":11.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":10.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":10.22,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":10.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":8.23,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":11.69,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":13.36,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.68,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.35,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":16.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.18,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":12.53,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":16.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":9.90,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":9.90,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":9.90,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":9.90,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":14.10,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":20.02,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":22.88,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":9.72,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":14.30,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":28.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.15,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":21.45,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":28.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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[50000]","standard_charge_dollar":8.31,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":6.76,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":7.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":7.39,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":8.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":8.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":8.03,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":8.03,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":8.03,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.56,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":8.03,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.09,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.65,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":9.88,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.20,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.26,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":7.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.31,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":12.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":16.70,"discounted_cash":10.02,"minimum":3.09,"maximum":16.70,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":14.20,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":11.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":11.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":11.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":9.99,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":11.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":10.40,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":9.99,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":11.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":11.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":10.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":10.22,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":10.86,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":8.23,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":11.69,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":13.36,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.68,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.35,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":16.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.18,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":12.53,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":16.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":11.87,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":13.30,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":13.30,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":12.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":12.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":12.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":12.15,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":12.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":9.79,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":13.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":15.88,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":6.75,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":9.93,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":19.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.96,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":14.89,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":19.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":11.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":11.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":11.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":11.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":11.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":12.98,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":5.76,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":19.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":19.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":19.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":19.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":13.36,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":19.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":19.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":19.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":30.75,"discounted_cash":18.45,"minimum":4.96,"maximum":30.75,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":26.14,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":20.70,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":20.70,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":20.70,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":20.70,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":16.83,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":20.60,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":18.39,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":20.60,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":19.16,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":18.39,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":20.60,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":20.60,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":19.99,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":19.99,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":19.99,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":18.82,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":19.99,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":15.16,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":21.53,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":24.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":10.46,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":15.38,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":30.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.69,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":23.06,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":30.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":18.23,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":18.23,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":18.23,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":28.09,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":29.84,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":22.63,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":34.43,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":45.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":27.21,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":19.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.96,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":14.89,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":16.12,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":16.12,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":15.18,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":16.12,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":12.23,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":17.36,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":19.84,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":8.43,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":12.40,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":24.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":6.20,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":18.60,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":24.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":14.70,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":14.70,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":14.70,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":14.70,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":14.70,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":24.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":24.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":24.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":16.70,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":24.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":24.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":192.69,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":181.43,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":192.69,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":100.79,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":148.23,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":296.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":60.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":60.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":58.27,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":58.27,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":58.27,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":54.87,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":58.27,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":44.20,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":62.76,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":71.72,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":30.48,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":44.83,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":89.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":22.41,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":67.24,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":89.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":53.14,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":53.14,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":53.14,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":53.14,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":53.14,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":58.60,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":26.00,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":89.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":89.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":89.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":89.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":60.35,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":89.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":89.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":89.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":92.00,"discounted_cash":55.20,"minimum":22.41,"maximum":89.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":78.20,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":87.40,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":61.93,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":78.20,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":61.93,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":61.93,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":61.93,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":55.02,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":61.64,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":57.32,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":55.02,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":61.64,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":61.64,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":59.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":59.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":59.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":56.30,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":59.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":45.36,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":28.35,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":32.40,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":13.77,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":20.25,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":40.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":10.13,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":30.38,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":40.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":24.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":40.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":40.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":42.90,"discounted_cash":25.74,"minimum":10.13,"maximum":42.90,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":27.89,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":26.25,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":27.89,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":14.59,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":21.45,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":42.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":10.73,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":32.18,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":42.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":25.43,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":25.43,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":25.43,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":42.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":42.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":42.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":30.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":30.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":28.37,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":37.08,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":15.76,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":23.18,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":46.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":11.59,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":34.76,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":46.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":27.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":27.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":27.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":27.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":27.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":30.30,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":13.44,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":46.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":46.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":46.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":46.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":31.20,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":46.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":46.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":29.75,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":33.33,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":30.99,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":29.75,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":33.33,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":33.33,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":30.45,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":32.34,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":24.53,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":38.99,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":36.26,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":34.80,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":37.83,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":37.83,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":37.83,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":19.79,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":29.10,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.47,"standard_charge_algorithm":"Fee schedule rate ($1.47).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":43.65,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":34.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":34.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":34.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":34.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":34.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":1.40,"standard_charge_algorithm":"Fee schedule rate ($1.40).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) 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file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":39.18,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"DIVALPROEX 125 MG CAPSULE DELAYED RELEASE 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months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":10.77,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":13.60,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":10.77,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":10.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":9.97,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":9.57,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.40,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.40,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.79,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":12.80,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.44,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":16.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.00,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":12.00,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":16.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":9.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":9.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[40033]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":12.40,"discounted_cash":7.44,"minimum":1.75,"maximum":11.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":10.54,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":8.35,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":8.35,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":8.35,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":8.35,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":6.79,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":7.73,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":7.73,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":8.31,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":7.73,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":7.79,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":6.56,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":8.31,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":7.42,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":8.31,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":7.73,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":7.42,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":8.31,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":8.31,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":8.06,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":8.06,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":8.06,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.59,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":8.06,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.11,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.68,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":9.92,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.22,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.20,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.10,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.30,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":12.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.35,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.35,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.35,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":7.35,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":7.35,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":8.11,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":3.60,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":12.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":12.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":12.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":12.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.35,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":12.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":12.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":12.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":24.65,"discounted_cash":14.79,"minimum":1.75,"maximum":23.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":12.15,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":17.26,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":19.72,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":78.79,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":105.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":62.27,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":79.01,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":74.39,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":79.01,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":59.92,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":85.09,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":97.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":41.33,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":60.78,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":121.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":30.39,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":91.16,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":121.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"DOXYCYCLINE HYCLATE 100 MG 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":41.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":10.41,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN 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file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":41.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":28.04,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":41.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":41.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":41.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":69.10,"discounted_cash":41.46,"minimum":10.41,"maximum":69.10,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":58.74,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":46.52,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":46.52,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":46.30,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":44.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":44.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":44.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":42.29,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":44.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":34.07,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":48.37,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":55.28,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":23.49,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":34.55,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":69.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":17.28,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":51.83,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":69.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":40.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":40.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":40.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":40.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":40.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":45.17,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":69.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":69.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":46.52,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":69.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":69.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":69.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":47.48,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":47.48,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":44.71,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":58.44,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":24.84,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":36.53,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":73.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":18.26,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":54.79,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":73.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":43.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":43.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":49.18,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":73.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":73.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":43.95,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":40.87,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":39.23,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 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15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":42.64,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":42.64,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":40.15,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for 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the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":65.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":16.40,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":49.20,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":65.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":38.89,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":38.89,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":59.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":118.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":29.50,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":88.50,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":118.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":69.95,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"FENOFIBRATE 54 MG 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":46.02,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":43.33,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":46.02,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":34.90,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":49.56,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":56.64,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":24.07,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":35.40,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":70.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":17.70,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":53.10,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":70.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":41.97,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":41.97,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":46.28,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":70.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":70.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":47.66,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":70.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":70.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":70.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed 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[5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":10.54,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":8.56,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":9.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":9.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":10.49,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":9.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":9.83,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":8.28,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":10.49,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":9.36,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":10.49,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":9.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":9.36,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":10.49,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":10.49,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":10.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.58,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":10.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":7.72,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":10.96,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":12.52,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.32,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":7.83,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.91,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":11.74,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":9.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":9.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":9.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":9.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":9.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":10.23,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.54,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":10.54,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":15.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":16.10,"discounted_cash":9.66,"minimum":1.75,"maximum":15.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":13.69,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":10.84,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":10.84,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":10.84,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":10.84,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":8.81,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":10.03,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":10.03,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":10.79,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":10.03,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":10.11,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":8.52,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":10.79,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":9.63,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":10.79,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":10.03,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":9.63,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":10.79,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":10.79,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":10.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.85,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":10.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":7.94,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":11.27,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":12.88,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.47,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.05,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":16.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":21.90,"discounted_cash":13.14,"minimum":1.75,"maximum":20.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":18.62,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":14.74,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":14.74,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":13.64,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":13.10,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":14.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":14.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":14.24,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":14.24,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":14.24,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":13.40,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":14.24,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":10.80,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":15.33,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":17.52,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":7.45,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":10.95,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":21.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":69.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":69.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":65.67,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":69.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":52.90,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":75.11,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":85.84,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":36.48,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":53.65,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":107.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":26.83,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":80.48,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":107.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":63.61,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":63.61,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":63.61,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":63.61,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":63.61,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":70.14,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":31.12,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":107.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":107.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":107.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":107.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":72.23,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":107.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":107.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent 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[50009]","standard_charge_dollar":134.43,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":95.26,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":120.28,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":86.60,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":91.98,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":69.76,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":99.05,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":113.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":48.11,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":70.75,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":141.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":35.38,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":106.13,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":141.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":83.88,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":83.88,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":92.50,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":41.04,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":8.59,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":11.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":6.79,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":11.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":11.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":11.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":11.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":11.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"FOLIC ACID 1 MG 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS 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BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":10.60,"discounted_cash":6.36,"minimum":1.75,"maximum":10.60,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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KS EXCHANGE HMO [40026]","standard_charge_dollar":7.10,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":6.34,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":7.10,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":6.89,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":6.49,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":6.89,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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[4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":9.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":9.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":9.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":10.58,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":14.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":8.36,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":14.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":14.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":14.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":14.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":9.49,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":14.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":14.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":14.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":52.75,"discounted_cash":31.65,"minimum":1.75,"maximum":50.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":35.34,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":34.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":34.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":14.00,"discounted_cash":8.40,"minimum":1.75,"maximum":14.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":9.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":8.57,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":9.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.76,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":7.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":124.05,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":115.35,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":110.72,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":124.05,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":124.05,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":120.35,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":120.35,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":120.35,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":113.31,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":9.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":9.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":9.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":10.50,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":9.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":185.15,"discounted_cash":111.09,"minimum":1.75,"maximum":175.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":157.38,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":124.64,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":124.64,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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[4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":124.05,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":110.72,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":124.05,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":120.35,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":113.31,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":120.35,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":9.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":8.57,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":9.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.90,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":9.80,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":11.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.76,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":7.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.50,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":10.50,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":9.15,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.06,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":9.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":14.00,"discounted_cash":8.40,"minimum":1.75,"maximum":13.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":11.90,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":9.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":9.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":9.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":9.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":7.66,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":8.72,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":8.72,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":9.38,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":8.72,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":8.79,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":7.41,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":9.38,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":8.37,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":9.38,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":8.72,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":8.37,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":9.38,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":9.38,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":9.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":9.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":9.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":8.57,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":9.10,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.90,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":9.80,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":11.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.76,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":7.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.50,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":10.50,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":8.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":9.15,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.06,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":14.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"HC Dx Clavicle Bilat","code_information":[{"code":"0320","type":"RC"},{"code":"73000","type":"CPT"},{"code":"PX-32010126","type":"CDM"}],"standard_charges":[{"gross_charge":1193.00,"discounted_cash":715.80,"minimum":25.01,"maximum":1133.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":1014.05,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":1133.35,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":803.13,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":1014.05,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":803.13,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":25.01,"standard_charge_algorithm":"Fee schedule rate ($25.01).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":743.24,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":743.24,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":631.10,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":799.31,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":713.41,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":799.31,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":743.24,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":713.41,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":1193.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":707.21,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":707.21,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":42.05,"standard_charge_algorithm":"Fee schedule rate ($42.05).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"HEALTHY BLUE KANSAS [22577]","standard_charge_dollar":50.69,"standard_charge_algorithm":"Fee schedule rate ($50.69).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER BEHAVIORAL HEALTH [22503]","standard_charge_dollar":48.74,"standard_charge_algorithm":"Fee schedule rate 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file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":803.13,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":1193.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":1193.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":775.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":775.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":775.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":41.28,"standard_charge_algorithm":"Fee schedule rate ($41.28).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":775.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":588.15,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":138.96,"standard_charge_algorithm":"Fee schedule rate ($138.96).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":954.40,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":405.62,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":596.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":1193.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":251.00,"standard_charge_algorithm":"Per diem ($251).","count":"0","methodology":"per diem","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":894.75,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":1193.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":707.21,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":707.21,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":707.21,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":707.21,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST 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file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER BEHAVIORAL HEALTH [22503]","standard_charge_dollar":48.74,"standard_charge_algorithm":"Fee schedule rate ($48.74).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER STATE HEALTH [22505]","standard_charge_dollar":53.61,"standard_charge_algorithm":"Fee schedule rate ($53.61).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"UHC COMMUNITY PLAN OF KS [22508]","standard_charge_dollar":48.74,"standard_charge_algorithm":"Fee schedule rate ($48.74).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"ZZZAETNA BETTER HEALTH OF KANSAS [22571]","standard_charge_dollar":50.69,"standard_charge_algorithm":"Fee schedule rate ($50.69).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":345.97,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":1193.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final 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[4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":532.65,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":475.41,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":532.65,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":516.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":41.28,"standard_charge_algorithm":"Fee schedule rate ($41.28).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":516.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER STATE HEALTH [22505]","standard_charge_dollar":53.61,"standard_charge_algorithm":"Fee schedule rate ($53.61).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"UHC COMMUNITY PLAN OF KS [22508]","standard_charge_dollar":48.74,"standard_charge_algorithm":"Fee schedule rate ($48.74).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"ZZZAETNA BETTER HEALTH OF KANSAS [22571]","standard_charge_dollar":50.69,"standard_charge_algorithm":"Fee schedule rate ($50.69).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or 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CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":401.33,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":373.18,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":376.17,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":401.33,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":373.18,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":358.20,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":389.35,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":389.35,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":26.37,"standard_charge_algorithm":"Fee schedule rate ($26.37).","count":"0","methodology":"fee 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":599.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":251.00,"standard_charge_algorithm":"Per diem ($251).","count":"0","methodology":"per diem","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":449.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed 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file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":403.25,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":599.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":599.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":599.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"HC Dx Foot 1 View Rt","code_information":[{"code":"0320","type":"RC"},{"code":"73620","type":"CPT"},{"code":"PX-32042742","type":"CDM"}],"standard_charges":[{"gross_charge":599.00,"discounted_cash":359.40,"minimum":21.58,"maximum":569.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":509.15,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA 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posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":389.35,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":389.35,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":389.35,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in 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prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":1206.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"HC Dx Hand Min 3 Views Left","code_information":[{"code":"0320","type":"RC"},{"code":"73130","type":"CPT"},{"code":"PX-32010240","type":"CDM"}],"standard_charges":[{"gross_charge":804.00,"discounted_cash":482.40,"minimum":29.47,"maximum":763.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":683.40,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":289.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":219.88,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":175.16,"standard_charge_algorithm":"Fee schedule rate ($175.16).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":446.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":264.39,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":264.39,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":229.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":229.45,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":46.71,"standard_charge_algorithm":"Fee schedule rate ($46.71).","count":"0","methodology":"fee 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15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":512.20,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":388.48,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":180.80,"standard_charge_algorithm":"Fee schedule rate ($180.80).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":475.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":41.28,"standard_charge_algorithm":"Fee schedule rate ($41.28).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":475.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":397.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":26.37,"standard_charge_algorithm":"Fee schedule rate ($26.37).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":397.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":1171.98,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":1244.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":944.10,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":957.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":1915.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":460.00,"standard_charge_algorithm":"Per diem ($460).","count":"0","methodology":"per diem","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":1436.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":1915.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":1135.21,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":460.00,"standard_charge_algorithm":"Per diem ($460).","count":"0","methodology":"per diem","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":1436.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":1915.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"HEALTHY BLUE KANSAS [22577]","standard_charge_dollar":37.04,"standard_charge_algorithm":"Fee schedule rate ($37.04).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER BEHAVIORAL HEALTH [22503]","standard_charge_dollar":108.00,"standard_charge_algorithm":"Fee schedule rate ($108).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER STATE HEALTH [22505]","standard_charge_dollar":39.18,"standard_charge_algorithm":"Fee schedule rate ($39.18).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the 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15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":910.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":1821.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":460.00,"standard_charge_algorithm":"Per diem ($460).","count":"0","methodology":"per diem","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":900.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":452.91,"standard_charge_algorithm":"Fee schedule rate ($452.91).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":900.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":471.24,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":693.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":1386.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":460.00,"standard_charge_algorithm":"Per diem ($460).","count":"0","methodology":"per diem","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":1039.50,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":1386.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":2883.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":1709.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":1709.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER STATE HEALTH [22505]","standard_charge_dollar":87.32,"standard_charge_algorithm":"Fee schedule rate ($87.32).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"UHC COMMUNITY PLAN OF KS [22508]","standard_charge_dollar":79.38,"standard_charge_algorithm":"Fee schedule rate ($79.38).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"ZZZAETNA BETTER HEALTH OF KANSAS [22571]","standard_charge_dollar":82.56,"standard_charge_algorithm":"Fee schedule rate ($82.56).","count":"0","methodology":"fee 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the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":26.37,"standard_charge_algorithm":"Fee schedule rate ($26.37).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":1073.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":814.44,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":826.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":1652.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":246.00,"standard_charge_algorithm":"Per diem ($246).","count":"0","methodology":"per diem","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":1239.00,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":1652.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":979.31,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"ZZZAETNA BETTER HEALTH OF KANSAS [22571]","standard_charge_dollar":12.79,"standard_charge_algorithm":"Fee schedule rate ($12.79).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":479.08,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":1652.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final 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the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":1629.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":3259.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":460.00,"standard_charge_algorithm":"Per diem ($460).","count":"0","methodology":"per diem","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":2444.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":3259.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":1931.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER BEHAVIORAL HEALTH [22503]","standard_charge_dollar":79.38,"standard_charge_algorithm":"Fee schedule rate ($79.38).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER STATE HEALTH [22505]","standard_charge_dollar":87.32,"standard_charge_algorithm":"Fee schedule rate ($87.32).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"UHC COMMUNITY PLAN OF KS [22508]","standard_charge_dollar":79.38,"standard_charge_algorithm":"Fee schedule rate ($79.38).","count":"0","methodology":"fee 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15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":1066.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":2133.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":460.00,"standard_charge_algorithm":"Per diem ($460).","count":"0","methodology":"per diem","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":977.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":50.59,"standard_charge_algorithm":"Fee schedule rate ($50.59).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":977.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"HYDROXYZINE HCL 10 MG\/5 ML ORAL 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the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":1667.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":1667.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":10280.60,"discounted_cash":6168.36,"minimum":416.85,"maximum":9766.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":10.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":9.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":9.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.18,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.91,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":9.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":10.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final 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item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":11.34,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":12.00,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":12.96,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item 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for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":12.15,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":15.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":16.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":8.89,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":9.60,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":8.89,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.18,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.91,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":9.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":445.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":445.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":419.56,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":445.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":337.98,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":479.89,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":685.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":406.39,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":406.39,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"LAMOTRIGINE 25 MG 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":35.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":8.78,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":26.33,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":35.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":20.81,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":20.81,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":35.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":35.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":35.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":31.60,"discounted_cash":18.96,"minimum":1.75,"maximum":30.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":26.86,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":21.27,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":21.27,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":21.27,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":21.27,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":17.29,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":19.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":19.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":21.17,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":19.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":19.84,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":16.72,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":21.17,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":18.90,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":21.17,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":19.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":18.90,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":21.17,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":21.17,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":20.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":20.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":20.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":19.34,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":20.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":15.58,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":22.12,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":25.28,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":10.74,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":15.80,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":31.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.90,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":23.70,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":31.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":18.73,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":18.73,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":18.73,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":18.73,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":18.73,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":20.66,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":9.16,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":31.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":31.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":31.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":31.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":21.27,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":31.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":31.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":31.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":31.55,"discounted_cash":18.93,"minimum":1.75,"maximum":29.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":19.66,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":18.87,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":21.14,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":20.51,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":19.31,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":20.51,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":15.55,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":22.09,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":25.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":10.73,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":15.78,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":31.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.89,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":23.66,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":31.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":31.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":31.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":21.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":31.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":31.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":31.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[50009]","standard_charge_dollar":26.17,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":18.55,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":23.42,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":18.55,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":18.55,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":18.55,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":16.47,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":18.46,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":17.16,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":16.47,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":18.46,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":18.46,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":17.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":17.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":17.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":16.86,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":17.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":13.58,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":19.29,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":22.04,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":9.37,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":13.78,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":6.89,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":20.66,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":16.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":16.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":16.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":16.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":16.86,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":17.91,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":13.58,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":19.29,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":22.04,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":9.37,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":13.78,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":6.89,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":20.66,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":16.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":16.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":16.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":16.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":16.33,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":18.01,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":7.99,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":18.55,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":27.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":31.45,"discounted_cash":18.87,"minimum":6.89,"maximum":29.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":26.73,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":21.17,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":21.17,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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[40012]","standard_charge_dollar":19.59,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":19.59,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":21.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":21.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":18.81,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":21.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":19.59,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":18.81,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":21.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":21.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":20.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":20.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":20.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":19.25,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":20.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":15.50,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":22.02,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":25.16,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":10.69,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":15.73,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":31.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.86,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":23.59,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":31.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":18.64,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":18.64,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":18.64,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":18.64,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":18.64,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":20.56,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":157.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":39.33,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":117.98,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in 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the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":186.57,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":198.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":150.29,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":152.43,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":76.21,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":228.64,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":261.20,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":145.11,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":213.40,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":426.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":186.57,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":198.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":150.29,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":152.43,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":76.21,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":228.64,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"LISDEXAMFETAMINE 30 MG 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15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":204.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":204.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":304.85,"discounted_cash":182.91,"minimum":51.19,"maximum":304.85,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[40012]","standard_charge_dollar":189.92,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":189.92,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":204.25,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE 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[4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":204.25,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":182.30,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":204.25,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":204.25,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":198.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":198.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":198.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":186.57,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":198.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":150.29,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":213.40,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":243.88,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":103.65,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":152.43,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":76.21,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":228.64,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":199.28,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":88.41,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":205.23,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":426.80,"discounted_cash":256.08,"minimum":51.19,"maximum":405.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":362.78,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":405.46,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":287.32,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":362.78,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":287.32,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":287.32,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":287.32,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":287.32,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":233.54,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":265.90,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":265.90,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":225.78,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":285.96,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":255.23,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":285.96,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":265.90,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":255.23,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":285.96,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":285.96,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":261.20,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":210.41,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":298.76,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":341.44,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":145.11,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":213.40,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":426.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":106.70,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":320.10,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":426.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":253.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":253.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":255.23,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":285.96,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":285.96,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":261.20,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":210.41,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":213.40,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":426.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":106.70,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":320.10,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":426.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":253.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":253.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":253.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":253.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":253.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":279.00,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":123.77,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":426.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":287.32,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":426.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":426.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":426.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"LISDEXAMFETAMINE 50 MG 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the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":195.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":195.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":195.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":153.28,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":194.13,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":173.27,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":194.13,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":180.51,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":173.27,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":194.13,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":194.13,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":188.34,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":188.34,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":188.34,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":177.33,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":289.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":72.44,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":217.31,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":289.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":171.76,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC 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file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":289.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":195.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":289.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":289.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":289.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":304.85,"discounted_cash":182.91,"minimum":72.44,"maximum":304.85,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":259.12,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":205.23,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":205.23,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":204.25,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":198.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":198.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":198.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":186.57,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":198.15,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":103.65,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":152.43,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":76.21,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":228.64,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":304.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":180.72,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":199.28,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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[50010]","standard_charge_dollar":287.32,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":287.32,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":287.32,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":261.20,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":277.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":210.41,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":298.76,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":426.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":106.70,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":320.10,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":426.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":253.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":253.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"LITHIUM CARBONATE ER 450 MG TABLET EXTENDED 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the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":207.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":207.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":207.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":3086.81,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":3086.81,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":3319.68,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":3086.81,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":3111.58,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":2621.06,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":3319.68,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":2962.94,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":3319.68,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments 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the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":3335.54,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":4954.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":4954.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for 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months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":13.90,"discounted_cash":8.34,"minimum":1.75,"maximum":13.90,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":11.82,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":9.36,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":9.36,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":8.66,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":8.31,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":9.31,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":9.31,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":9.04,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":9.04,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":9.04,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":8.51,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":9.04,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.85,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":9.73,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":11.12,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.73,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.95,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":13.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.48,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":10.43,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":13.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":8.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":8.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":8.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":8.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":8.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":9.09,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":13.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":13.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":13.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":13.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":9.36,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":13.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":13.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":13.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":16.20,"discounted_cash":9.72,"minimum":1.75,"maximum":15.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":13.77,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":15.39,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":10.91,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":13.77,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":10.91,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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[50016]","standard_charge_dollar":8.86,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":10.09,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":10.09,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":8.57,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":10.85,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":9.69,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":10.85,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":10.09,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":9.69,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.91,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":16.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":16.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":16.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":43.78,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":43.78,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":33.20,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":26.94,"standard_charge_percentage":40.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":53.88,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":22.90,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":33.68,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":67.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":2.06,"standard_charge_algorithm":"Fee schedule rate ($2.06).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":50.51,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":67.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":39.93,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST 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file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":67.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":67.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":67.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":45.34,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":67.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":67.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":67.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":81.30,"discounted_cash":48.78,"minimum":1.38,"maximum":77.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":69.11,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":77.24,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total 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service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":54.73,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":54.73,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":54.73,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":44.49,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":50.65,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":50.65,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":54.47,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":50.65,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":51.06,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":43.01,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":54.47,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":48.62,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":54.47,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":50.65,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":48.62,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":54.47,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":54.47,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":52.85,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":52.85,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":52.85,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":52.85,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":40.08,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":32.52,"standard_charge_percentage":40.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":65.04,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":27.64,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":40.65,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":81.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":2.06,"standard_charge_algorithm":"Fee schedule rate ($2.06).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":60.98,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":81.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":48.19,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":48.19,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":48.19,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":48.19,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":48.19,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":3.05,"standard_charge_algorithm":"Fee schedule rate ($3.05).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"HEALTHY BLUE KANSAS [22577]","standard_charge_dollar":1.44,"standard_charge_algorithm":"Fee schedule rate ($1.44).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER BEHAVIORAL HEALTH [22503]","standard_charge_dollar":1.38,"standard_charge_algorithm":"Fee schedule rate ($1.38).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER STATE HEALTH [22505]","standard_charge_dollar":1.52,"standard_charge_algorithm":"Fee schedule rate ($1.52).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID 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or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":81.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":81.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"LOSARTAN 50 MG 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to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":11.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":11.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"LOXAPINE SUCCINATE 5 MG 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":162.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":162.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":153.09,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":162.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":123.32,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":175.11,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":200.12,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":85.05,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":125.08,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":250.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":62.54,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":187.61,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":250.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":148.29,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":148.29,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":148.29,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":148.29,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":148.29,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":163.52,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":72.54,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":250.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":250.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":250.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":250.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":168.40,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":250.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM 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BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":8.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":8.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.80,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":10.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.34,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.38,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.19,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.56,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":43.14,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":54.64,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":48.77,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":54.64,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":50.81,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":48.77,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":54.64,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":54.64,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":53.01,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":53.01,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":53.01,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":49.91,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":53.01,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":40.20,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":57.09,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final 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the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":81.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":20.39,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":61.16,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":81.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":48.34,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":48.34,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":54.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":81.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":81.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent 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posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":585.78,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":585.78,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":585.78,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":551.53,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":585.78,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":444.29,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":630.84,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":720.96,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":306.41,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":450.60,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":901.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":225.30,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":675.90,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":901.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":534.23,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":534.23,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":534.23,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":534.23,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":534.23,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":589.11,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":261.35,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":901.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":901.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":901.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":901.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":606.69,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":901.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":901.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":901.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"LURASIDONE 60 MG 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for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":8.58,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":10.84,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":8.58,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":8.54,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":7.94,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":7.62,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":8.54,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":8.54,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":8.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":8.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":8.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.80,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":8.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.29,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.93,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":10.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.34,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.38,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.19,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.56,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":12.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.56,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.56,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.56,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":7.56,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":7.56,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":8.33,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":3.70,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":12.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":12.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":12.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":12.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.58,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":12.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":12.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[50006]","standard_charge_dollar":54.63,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":54.63,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":54.63,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":49.66,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":52.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":40.01,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":60.86,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":81.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":48.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":81.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":81.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"LURASIDONE 80 MG 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":54.50,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":54.50,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":51.32,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":2.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":2.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"MAGNESIUM OXIDE 400 MG (241.3 MG MAGNESIUM) 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":487.29,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":487.29,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":472.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":472.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":472.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":472.75,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":290.92,"standard_charge_percentage":40.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":247.28,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":144.00,"standard_charge_algorithm":"Fee schedule rate ($144).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":727.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":431.14,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":431.14,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST 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15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":210.92,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":727.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":727.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":727.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":727.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":727.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"MELOXICAM 7.5 MG 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":15.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":9.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":9.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":15.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":15.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":15.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":9.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":9.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":54.75,"discounted_cash":32.85,"minimum":2.33,"maximum":52.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":44.07,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":41.49,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":44.07,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":33.43,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":47.46,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":54.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":16.95,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":50.85,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":67.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":40.19,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":40.19,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":40.19,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":28.08,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":31.46,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":31.46,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":28.73,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":30.52,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":23.15,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":32.87,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":37.56,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":15.96,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":23.48,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":46.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":11.74,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":35.21,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":46.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":27.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":27.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":27.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":27.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":27.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":30.69,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":13.62,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":46.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":46.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":46.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":46.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":31.61,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":46.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":46.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":46.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":56.30,"discounted_cash":33.78,"minimum":11.74,"maximum":53.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":47.86,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":37.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":37.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":37.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":37.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":30.81,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":35.07,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":35.07,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":37.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":37.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":33.67,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":37.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":35.07,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":33.67,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":37.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":37.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":36.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":36.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":36.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":34.46,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":36.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":27.76,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":39.41,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":45.04,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":19.14,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":28.15,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":56.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":14.08,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":42.23,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":56.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":33.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":33.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":33.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":33.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":33.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":36.80,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":16.33,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":56.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":56.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":56.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":56.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":37.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":56.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":56.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":56.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":14.63,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":15.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":11.78,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":11.95,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":23.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":5.98,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":17.93,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":23.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":14.17,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":23.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":23.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":23.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final 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[50014]","standard_charge_dollar":114.62,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":90.78,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":90.78,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":87.65,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":82.53,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":87.65,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":66.48,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":94.40,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":107.88,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":45.85,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":67.43,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":134.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":33.71,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":101.14,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":134.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":79.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":79.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":79.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":79.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":79.94,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":88.15,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":39.11,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":134.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":134.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":114.70,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":106.66,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":102.38,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":114.70,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":114.70,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":111.28,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":111.28,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":111.28,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":104.77,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":111.28,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":84.40,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":119.84,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":136.96,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":58.21,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":85.60,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":171.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":42.80,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":128.40,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":171.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":101.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":101.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":101.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":101.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":101.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":111.91,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":49.65,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":171.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":171.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":171.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":171.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":115.25,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":171.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":171.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":171.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":417.55,"discounted_cash":250.53,"minimum":5.98,"maximum":396.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":354.92,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":396.67,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":281.09,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":354.92,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA 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[50000]","standard_charge_dollar":281.09,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":228.48,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":260.13,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":260.13,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":279.76,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":260.13,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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[4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":249.69,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":279.76,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":260.13,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":249.69,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":279.76,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":279.76,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":271.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":271.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":271.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":255.54,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":271.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":205.85,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":292.29,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":334.04,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":141.97,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":208.78,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":417.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":104.39,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":313.16,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":417.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":247.52,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":247.52,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":247.52,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":247.52,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":247.52,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":272.95,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":121.09,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":88.51,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":85.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":85.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":85.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":80.85,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":85.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":65.13,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":92.47,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":105.68,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":44.91,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":66.05,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":132.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":33.03,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":99.08,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":132.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":78.31,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":78.31,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":78.31,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":78.31,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":78.31,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":86.35,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":38.31,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":132.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":132.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":132.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":132.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":88.93,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":132.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":132.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":132.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":136.10,"discounted_cash":81.66,"minimum":6.18,"maximum":136.10,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":115.69,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":129.30,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":91.62,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":115.69,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":91.62,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":91.62,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":91.62,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":91.62,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":74.47,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":84.79,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":84.79,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":72.00,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":91.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":81.39,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":91.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":84.79,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":81.39,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":91.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":91.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":88.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":88.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":88.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":83.29,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":88.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":67.10,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":95.27,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":108.88,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":46.27,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":68.05,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":136.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":34.03,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":102.08,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":136.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":80.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":80.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":80.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":80.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":80.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":88.97,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":39.47,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":136.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":136.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":136.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":136.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":171.28,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":161.26,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":171.28,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":89.59,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":131.75,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":263.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":65.88,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":197.63,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":263.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":263.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":263.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":177.39,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":7.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":7.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":7.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.01,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":7.44,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":5.64,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA 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[8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":5.73,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":11.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":2.86,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":11.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":11.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":11.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":7.52,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":10.68,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":12.20,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":9.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":9.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":9.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"METRONIDAZOLE 0.75 % (37.5 MG\/5 GRAM) VAGINAL 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":105.46,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":105.46,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":102.31,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":102.31,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":102.31,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":96.33,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":125.92,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":53.52,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":78.70,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":157.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":39.35,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":118.05,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":157.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":93.31,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":93.31,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":8.22,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.74,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":8.22,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.24,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.86,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":10.12,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":20.50,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":21.78,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":16.52,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":25.13,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":33.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":19.86,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":21.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":5.31,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":15.94,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed 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[5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":15.05,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":12.23,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":13.92,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":13.92,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":14.97,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":13.92,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":14.04,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":11.82,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":14.97,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":13.37,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":14.97,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":13.92,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":13.37,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":14.97,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":14.97,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":14.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":14.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":14.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":13.68,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":14.53,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":11.02,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":15.65,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":17.88,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":7.60,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":11.18,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":22.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":5.59,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":16.76,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":22.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":13.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":13.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":13.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":13.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":13.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":14.61,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":6.48,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":22.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":22.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":22.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":22.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":15.05,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":22.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":22.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":22.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":40.75,"discounted_cash":24.45,"minimum":5.31,"maximum":38.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":34.64,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":27.43,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":27.43,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":27.43,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":27.43,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":22.30,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":25.39,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":25.39,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":27.30,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":25.39,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":25.59,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":21.56,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":27.30,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":24.37,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":27.30,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":25.39,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":24.37,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":27.30,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":27.30,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":26.49,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":26.49,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":26.49,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":24.94,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":26.49,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":20.09,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":28.53,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":32.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":13.86,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":20.38,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":40.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":10.19,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":30.56,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":40.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":31.29,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":30.36,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":30.36,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":30.36,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":28.58,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":30.36,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":23.02,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":32.69,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":37.36,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":15.88,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":23.35,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":46.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":11.68,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":35.03,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":46.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":27.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":27.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":27.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":27.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":27.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":30.53,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":13.54,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":46.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":46.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":46.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":46.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":31.44,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":46.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":46.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":46.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":48.15,"discounted_cash":28.89,"minimum":7.79,"maximum":48.15,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":40.93,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":45.74,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":32.41,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":40.93,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":32.41,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":32.26,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":30.00,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":28.79,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":32.26,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":32.26,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":31.30,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":31.30,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":31.30,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":29.47,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":31.30,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":23.74,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":33.71,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":38.52,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":16.37,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":24.08,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":48.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":12.04,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":36.11,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":3.70,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"MIRTAZAPINE 15 MG DISINTEGRATING TABLET","drug_information":{"unit":1.00,"type":"UN"},"code_information":[{"code":"0250","type":"RC"},{"code":"0637","type":"RC"},{"code":"57237-0011-06","type":"NDC"},{"code":"A9270","type":"HCPCS"},{"code":"RX-29531","type":"CDM"}],"standard_charges":[{"gross_charge":11.60,"discounted_cash":6.96,"minimum":2.90,"maximum":11.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":9.86,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":7.81,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":7.81,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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KS EXCHANGE HMO [40026]","standard_charge_dollar":7.77,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":6.94,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":7.77,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":7.23,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":6.94,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":7.77,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":7.77,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":7.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":7.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":7.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.10,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":7.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":11.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":11.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":11.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":11.30,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":12.86,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":12.86,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":13.84,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":12.86,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":12.97,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":10.92,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":13.84,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":12.35,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":13.84,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":12.86,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":12.35,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":13.84,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":13.84,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":13.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":13.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":13.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":12.64,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":13.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":10.18,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":14.46,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":20.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":5.16,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":15.49,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":20.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":12.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":12.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":13.50,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":5.99,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH 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[3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":20.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":20.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":40.20,"discounted_cash":24.12,"minimum":5.16,"maximum":40.20,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":34.17,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":38.19,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":27.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":34.17,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":27.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":27.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":27.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":27.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":22.00,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":25.04,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":25.04,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":26.93,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":25.04,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":25.25,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":21.27,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":26.93,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":24.04,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":26.93,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":25.04,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":24.04,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":26.93,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":26.93,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":26.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":26.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":26.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":24.60,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":26.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":19.82,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":28.14,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":32.16,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":13.67,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":20.10,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":40.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":10.05,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":30.15,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":40.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":23.83,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior 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[50000]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":3.83,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":17.95,"discounted_cash":10.77,"minimum":1.75,"maximum":17.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":15.26,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":12.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":12.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":12.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":12.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":9.82,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":12.03,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":10.73,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":12.03,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":11.18,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":10.73,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":12.03,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":12.03,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":11.67,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":11.67,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":11.67,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":10.99,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":11.67,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":8.85,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":12.57,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":14.36,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":6.10,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.98,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":17.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":99.67,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":125.84,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":99.67,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":99.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":92.24,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":88.53,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":99.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":99.19,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":96.23,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":96.23,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":96.23,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":96.23,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":37.01,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":111.04,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":148.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":87.76,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":87.76,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":87.76,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST 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months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":87.76,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":87.76,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":87.76,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":87.76,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":87.76,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":96.78,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":42.93,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":148.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":148.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":148.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":148.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":99.67,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed 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total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"NALOXONE 0.4 MG\/ML INTRANASAL SOLUTION","drug_information":{"unit":0.10,"type":"ML"},"code_information":[{"code":"0250","type":"RC"},{"code":"70756-0658-10","type":"NDC"},{"code":"J2312","type":"HCPCS"},{"code":"RX-600869","type":"CDM"}],"standard_charges":[{"gross_charge":14.85,"discounted_cash":8.91,"minimum":3.71,"maximum":14.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":12.62,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY 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[4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":9.65,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":9.65,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":9.65,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.09,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":9.65,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":7.32,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA 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15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":38.48,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":38.48,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":36.23,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":47.36,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":20.13,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":29.60,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":59.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":14.80,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":44.40,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":59.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":35.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":35.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":61.81,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":57.47,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":55.17,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":59.96,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":59.96,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":56.46,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final 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[55116]","standard_charge_dollar":54.69,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":54.69,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":54.69,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":80.57,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":75.86,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":80.57,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":61.11,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":86.77,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":99.16,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":256.29,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":256.29,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":256.29,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":255.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":237.18,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":239.08,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":201.39,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":255.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":227.66,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":255.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":237.18,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":227.66,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":255.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":255.07,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":247.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":247.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":247.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":247.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":187.69,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":152.28,"standard_charge_percentage":40.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":304.56,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":129.44,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":190.35,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":380.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":95.18,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":285.53,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":380.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":225.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":225.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":225.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":225.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":225.68,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":18.32,"standard_charge_algorithm":"Fee schedule rate ($18.32).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"HEALTHY BLUE KANSAS [22577]","standard_charge_dollar":18.10,"standard_charge_algorithm":"Fee schedule rate ($18.10).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER BEHAVIORAL HEALTH [22503]","standard_charge_dollar":17.40,"standard_charge_algorithm":"Fee schedule rate ($17.40).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER STATE HEALTH [22505]","standard_charge_dollar":19.14,"standard_charge_algorithm":"Fee schedule rate ($19.14).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"UHC COMMUNITY PLAN OF KS [22508]","standard_charge_dollar":17.40,"standard_charge_algorithm":"Fee schedule rate ($17.40).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"ZZZAETNA BETTER HEALTH OF KANSAS [22571]","standard_charge_dollar":18.10,"standard_charge_algorithm":"Fee schedule rate ($18.10).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":110.40,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":380.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":380.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":380.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":380.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":256.29,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":380.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":380.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":380.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":421.90,"discounted_cash":253.14,"minimum":17.40,"maximum":421.90,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":358.62,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":400.81,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":284.02,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":358.62,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":284.02,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":284.02,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":284.02,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":284.02,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":230.86,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":262.84,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":262.84,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":282.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":262.84,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":264.95,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":223.19,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":282.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":252.30,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":282.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":262.84,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":252.30,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":282.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":282.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":274.24,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":274.24,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":274.24,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":274.24,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":208.00,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed 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the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":210.95,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":421.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":105.48,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed 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prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":252.92,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":283.38,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":263.50,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":252.92,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":283.38,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":283.38,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":274.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":274.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":274.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":274.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":208.51,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":169.18,"standard_charge_percentage":40.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item 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to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":422.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":105.74,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":317.21,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":18.32,"standard_charge_algorithm":"Fee schedule rate ($18.32).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"HEALTHY BLUE KANSAS [22577]","standard_charge_dollar":18.10,"standard_charge_algorithm":"Fee schedule rate ($18.10).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER BEHAVIORAL HEALTH [22503]","standard_charge_dollar":17.40,"standard_charge_algorithm":"Fee schedule rate ($17.40).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER STATE HEALTH [22505]","standard_charge_dollar":19.14,"standard_charge_algorithm":"Fee schedule rate ($19.14).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"UHC COMMUNITY PLAN OF KS [22508]","standard_charge_dollar":17.40,"standard_charge_algorithm":"Fee schedule rate ($17.40).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"ZZZAETNA BETTER HEALTH OF KANSAS [22571]","standard_charge_dollar":18.10,"standard_charge_algorithm":"Fee schedule rate ($18.10).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item 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payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":422.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":422.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":284.73,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":385.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":385.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":385.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":292.67,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":237.46,"standard_charge_percentage":40.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":474.92,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":148.41,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":445.24,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":593.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":351.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":351.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":351.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":351.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":351.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":18.32,"standard_charge_algorithm":"Fee schedule rate ($18.32).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"HEALTHY BLUE KANSAS [22577]","standard_charge_dollar":18.10,"standard_charge_algorithm":"Fee schedule rate ($18.10).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER BEHAVIORAL HEALTH [22503]","standard_charge_dollar":17.40,"standard_charge_algorithm":"Fee schedule rate ($17.40).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER STATE HEALTH [22505]","standard_charge_dollar":19.14,"standard_charge_algorithm":"Fee schedule rate ($19.14).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"UHC COMMUNITY PLAN OF KS [22508]","standard_charge_dollar":17.40,"standard_charge_algorithm":"Fee schedule rate ($17.40).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"ZZZAETNA BETTER HEALTH OF KANSAS [22571]","standard_charge_dollar":18.10,"standard_charge_algorithm":"Fee schedule rate ($18.10).","count":"0","methodology":"fee schedule","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":172.16,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":593.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":593.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":593.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[57513]","standard_charge_dollar":593.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":593.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":593.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":709.88,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":562.22,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":562.22,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":562.22,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":562.22,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":456.99,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":520.30,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":520.30,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":559.55,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":559.55,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":499.42,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":559.55,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":520.30,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":499.42,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":559.55,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final 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the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":417.58,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":835.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":208.79,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":626.36,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":835.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":495.08,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed 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[2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":835.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":562.22,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":835.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":835.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":835.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"OLANZAPINE 2.5 MG 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prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":5.95,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS 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BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":22.08,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":19.70,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":22.08,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":20.53,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":19.70,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":22.08,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":22.08,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":21.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":21.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":21.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":20.17,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":21.42,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":16.24,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":23.07,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":26.36,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":11.20,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":16.48,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":32.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":8.24,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":24.71,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":32.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":19.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":19.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":19.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":19.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":19.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":21.54,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":9.56,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":32.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":32.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":32.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":32.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":22.18,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":32.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":32.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":32.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":34.05,"discounted_cash":20.43,"minimum":4.09,"maximum":34.05,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":28.94,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":32.35,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":22.92,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":28.94,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":22.92,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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[50016]","standard_charge_dollar":18.63,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":21.21,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":21.21,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":22.81,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":21.21,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":20.36,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":22.81,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":22.81,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":22.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":22.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":22.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":20.84,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":22.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":16.79,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":23.84,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":27.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":11.58,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":17.03,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":34.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":8.51,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":25.54,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":34.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":20.18,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":20.18,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":37.16,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":49.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":29.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":91.68,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":86.32,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":91.68,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":98.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":98.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":92.78,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":98.54,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":74.74,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":106.12,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":121.28,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":51.54,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":75.80,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":151.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":37.90,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":113.70,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":151.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":89.87,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":89.87,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":89.87,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":89.87,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":89.87,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":151.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":151.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":151.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":102.06,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":151.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM 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prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":169.43,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":120.07,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":151.60,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":106.65,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":119.49,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":119.49,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":115.93,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":115.93,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":115.93,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":109.15,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":115.93,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":87.93,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":124.85,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":142.68,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":60.64,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":89.18,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":178.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":44.59,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":133.76,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":178.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":105.73,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":33.20,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":30.87,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":29.63,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":33.20,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":33.20,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":32.21,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 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the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":49.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":12.39,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":37.16,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":49.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":29.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":29.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":106.65,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":119.49,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":119.49,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":115.93,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":115.93,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":115.93,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":109.15,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":115.93,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":87.93,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":89.18,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":178.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":44.59,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":133.76,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":178.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":105.73,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":105.73,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":105.73,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":105.73,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":105.73,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":116.59,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":51.72,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":178.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":120.07,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":178.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":178.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":178.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":265.55,"discounted_cash":159.33,"minimum":12.39,"maximum":252.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":225.72,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":178.77,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":178.77,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":177.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":172.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":172.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":172.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":162.52,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":172.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":130.92,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":185.89,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":212.44,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":90.29,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":132.78,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":265.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":110.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":98.82,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":110.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":110.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":107.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":107.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":107.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":101.13,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":107.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":56.19,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":82.63,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":165.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":41.31,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":123.94,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":165.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":97.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":97.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":97.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":97.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":97.96,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":108.02,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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[50005]","standard_charge_dollar":130.87,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":165.24,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":130.87,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":130.25,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":121.11,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":116.25,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":130.25,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":130.25,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":126.36,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":126.36,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":126.36,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":118.97,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":126.36,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":95.84,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":136.08,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":155.52,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":66.10,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":97.20,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":194.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":48.60,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":145.80,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":194.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":115.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":115.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":115.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":115.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":115.24,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":194.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":194.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":194.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":274.98,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":194.86,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":246.03,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":173.09,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":193.93,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":193.93,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":188.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":188.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":188.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":177.14,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":188.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":142.70,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":144.73,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":289.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":72.36,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":217.09,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":289.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":171.59,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":171.59,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":171.59,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":171.59,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting 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[4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":7.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":7.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":7.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE 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[7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.40,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":9.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.08,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.00,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.00,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":16.30,"discounted_cash":9.78,"minimum":3.00,"maximum":16.30,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":13.86,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":10.97,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":10.97,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":10.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":9.75,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":10.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":10.15,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":9.75,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":10.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":10.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":10.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.98,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":10.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":8.04,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":11.41,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":13.04,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.54,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.15,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.08,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":12.23,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":9.66,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":9.66,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":9.66,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":9.66,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":9.66,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":10.66,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.73,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":14.16,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":6.02,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.85,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":17.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.43,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":13.28,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":17.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":10.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":10.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":10.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":10.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":10.49,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":17.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":17.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":17.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":11.92,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":17.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":17.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":8.04,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":7.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":7.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":7.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.34,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":7.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":5.92,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.40,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":9.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.08,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.00,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.00,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":7.84,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":3.48,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":16.30,"discounted_cash":9.78,"minimum":3.00,"maximum":16.30,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":13.86,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":15.49,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":10.97,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":13.86,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":10.97,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":10.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":10.15,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":9.75,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":10.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":10.92,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":10.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.98,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":10.60,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":8.04,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":11.41,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":13.04,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.54,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.15,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.08,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":12.23,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":9.66,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":9.66,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":10.66,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.73,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":10.97,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":16.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":27.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":27.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":26.85,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":26.85,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":26.85,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":25.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":26.85,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":20.36,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":28.91,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":33.04,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":14.04,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":20.65,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":41.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":10.33,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":30.98,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":41.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":24.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":24.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":24.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":24.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":24.48,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":27.00,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":11.98,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":41.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":41.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":41.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":41.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":27.80,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":41.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":41.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":41.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":275.50,"discounted_cash":165.30,"minimum":10.33,"maximum":261.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":234.18,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":261.73,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":185.47,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":234.18,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":185.47,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":185.47,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":185.47,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":185.47,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":150.75,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":171.64,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":171.64,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":184.59,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":171.64,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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[4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":164.75,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":184.59,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":171.64,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":164.75,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":184.59,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":184.59,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":179.08,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":179.08,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":179.08,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":168.61,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":179.08,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":135.82,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":192.85,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":220.40,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":93.67,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":137.75,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":275.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":68.88,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":206.63,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":275.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":163.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":163.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":163.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":163.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":163.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":180.09,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":79.90,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":275.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":275.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":275.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":275.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":185.47,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":275.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":4.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.19,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":12.70,"discounted_cash":7.62,"minimum":1.75,"maximum":12.70,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":10.80,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":12.07,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":8.55,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":10.80,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":8.55,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":8.55,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":8.55,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":8.55,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":6.95,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":7.91,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":7.91,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":8.51,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":7.91,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":7.98,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":6.72,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":8.51,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":7.59,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":8.51,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":7.91,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":7.59,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":8.51,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":8.51,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":8.26,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":8.26,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":8.26,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.77,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":8.26,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.26,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.89,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":10.16,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.32,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.35,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.18,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.53,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":12.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":7.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":7.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":8.30,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":3.68,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":12.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":12.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":12.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":12.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.55,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":12.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":27.37,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":25.45,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":24.43,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":27.37,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":27.37,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":26.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":26.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":26.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":25.00,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":26.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":20.14,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":28.60,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":32.68,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":13.89,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":20.43,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":40.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":10.21,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":30.64,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":40.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":24.22,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":24.22,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":24.22,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":24.22,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":24.22,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":26.70,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":11.85,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":40.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":40.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":40.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":40.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":27.50,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":40.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":40.85,"standard_charge_percentage":100.00,"count":"0","methodology":"percent 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[50009]","standard_charge_dollar":49.83,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":35.31,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":44.58,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL 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[40033]","standard_charge_dollar":32.68,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":35.14,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":32.68,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":31.37,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":35.14,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":32.68,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":31.37,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":35.14,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":35.14,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":34.09,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":34.09,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":34.09,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":32.10,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":34.09,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":25.86,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":36.72,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":41.96,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":17.83,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":26.23,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":52.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":13.11,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":39.34,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":52.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":31.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":31.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":31.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":31.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":31.09,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":34.29,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":15.21,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":52.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":52.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":52.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":52.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":35.31,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":52.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":52.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":52.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":53.35,"discounted_cash":32.01,"minimum":9.98,"maximum":53.35,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":45.35,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":35.92,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":35.92,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":35.74,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":34.68,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":34.68,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":34.68,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":32.65,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":34.68,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":26.30,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":37.35,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":42.68,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":18.14,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":26.68,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":53.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":13.34,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":40.01,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":53.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":31.63,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":31.63,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":31.63,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":31.63,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":31.63,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":34.87,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":53.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":53.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":53.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":153.30,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":144.34,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":153.30,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":18.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":17.07,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":18.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":19.23,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":19.23,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":18.66,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":18.66,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":18.66,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":17.56,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":18.66,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":14.15,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":20.09,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":22.96,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":9.76,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":14.35,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":28.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.18,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":21.53,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":28.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":17.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":17.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":17.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":17.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":17.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":28.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":28.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":28.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":19.32,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":28.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":28.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":19.23,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":21.54,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":20.03,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":19.23,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":21.54,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":21.54,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":20.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":20.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":20.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":19.68,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":20.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":15.85,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[50002]","standard_charge_dollar":19.12,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":19.12,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":15.54,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":17.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":17.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":19.03,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":17.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":17.84,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":15.02,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":19.03,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":16.98,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":19.03,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":17.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":16.98,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":19.03,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":19.03,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":18.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":18.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":18.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":17.38,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":18.46,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":14.00,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":19.88,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":22.72,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":9.66,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":14.20,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.10,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":21.30,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":16.84,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":16.84,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":16.84,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":16.84,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":16.84,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":18.57,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":8.24,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":19.12,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":28.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":28.80,"discounted_cash":17.28,"minimum":1.75,"maximum":28.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":24.48,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":27.36,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":19.39,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":24.48,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":19.39,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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[50016]","standard_charge_dollar":15.76,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":17.94,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":17.94,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":19.30,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":17.94,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":17.22,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":19.30,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":19.30,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":18.72,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":18.72,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":18.72,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":17.63,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"PSYCHOSES","code_information":[{"code":"885","type":"MS-DRG"}],"standard_charges":[{"gross_charge":17949.90,"discounted_cash":10769.94,"minimum":480.00,"maximum":17949.90,"setting":"inpatient","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":1696.00,"standard_charge_algorithm":"Per diem ($1,696).","median_amount":8480.00,"10th_percentile":6784.00,"90th_percentile":20056.40,"count":"20","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_percentage":85.00,"median_amount":92449.70,"10th_percentile":92449.70,"90th_percentile":92449.70,"count":"1 through 10","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":1696.00,"standard_charge_algorithm":"Per diem ($1,696).","median_amount":11872.00,"10th_percentile":8480.00,"90th_percentile":21330.60,"count":"16","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":1696.00,"standard_charge_algorithm":"Per diem ($1,696).","median_amount":10176.00,"10th_percentile":10176.00,"90th_percentile":10176.00,"count":"1 through 10","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":1696.00,"standard_charge_algorithm":"Per diem ($1,696).","count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay. Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":1696.00,"standard_charge_algorithm":"Per diem ($1,696).","median_amount":17690.00,"10th_percentile":17690.00,"90th_percentile":17690.00,"count":"1 through 10","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":1016.00,"standard_charge_algorithm":"Per diem ($1,016).","median_amount":8955.00,"10th_percentile":8955.00,"90th_percentile":8955.00,"count":"1 through 10","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":1524.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":1524.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":1599.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":1524.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":1423.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":1524.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":1599.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_percentage":59.80,"median_amount":16513.52,"10th_percentile":10910.51,"90th_percentile":317160.88,"count":"1 through 10","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":1599.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":1524.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":1599.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":1599.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":1556.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":1556.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":1556.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":1540.00,"standard_charge_algorithm":"Per diem ($1,540).","count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay. Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":1556.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":1938.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":989.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":1000.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":926.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CHC SE KS LUMINARE EMPLOYEE PLAN [80085]","standard_charge_dollar":20330.62,"standard_charge_algorithm":"Case rate ($12,706.64). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $10,861.29 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount. Final payment is multiplied by 160%.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Benefit Plans 80085 160% Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":480.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_percentage":75.00,"median_amount":16466.46,"10th_percentile":16466.46,"90th_percentile":16466.46,"count":"1 through 10","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":1775.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_percentage":59.28,"median_amount":15414.25,"10th_percentile":15414.25,"90th_percentile":15631.96,"count":"1 through 10","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":1657.00,"standard_charge_algorithm":"Per diem ($1,657).","count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay. Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"HEALTHY BLUE KANSAS [22577]","standard_charge_dollar":3154.13,"standard_charge_algorithm":"Fee schedule rate ($3,154.13).","median_amount":9250.02,"10th_percentile":5490.31,"90th_percentile":48349.02,"count":"16","methodology":"case rate","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER BEHAVIORAL HEALTH [22503]","standard_charge_dollar":3032.82,"standard_charge_algorithm":"Fee schedule rate ($3,032.82).","median_amount":7579.05,"10th_percentile":4115.56,"90th_percentile":13413.67,"count":"21","methodology":"case rate","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"SUNFLOWER STATE HEALTH [22505]","standard_charge_dollar":3336.10,"standard_charge_algorithm":"Fee schedule rate ($3,336.10).","median_amount":3270.60,"10th_percentile":3270.60,"90th_percentile":3270.60,"count":"1 through 10","methodology":"case rate","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"UHC COMMUNITY PLAN OF KS [22508]","standard_charge_dollar":3032.82,"count":"0","methodology":"case rate","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (KS) [2252]","plan_name":"ZZZAETNA BETTER HEALTH OF KANSAS [22571]","standard_charge_dollar":3154.13,"standard_charge_algorithm":"Fee schedule rate ($3,154.13).","count":"0","methodology":"case rate","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICARE REPLACEMENT PLAN [1250]","plan_name":"DEVOTED HEALTH MEDICARE ADVANTAGE [12532]","standard_charge_dollar":12037.77,"standard_charge_algorithm":"Case rate ($11,464.54). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $9,619.18 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount. Final payment is multiplied by 105%.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Benefit Plan 12532 105% Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICARE REPLACEMENT PLAN [1250]","plan_name":"OPTUM UHC MEDICARE ADVANTAGE [12508]","standard_charge_dollar":11693.83,"standard_charge_algorithm":"Case rate ($11,464.54). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $9,619.18 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount. Final payment is multiplied by 102%.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Benefit Plan 12507,12508,12509,12521,12522 102% Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICARE REPLACEMENT PLAN [1250]","plan_name":"UHC DUAL COMPLETE SNP KS [12521]","standard_charge_dollar":11693.83,"standard_charge_algorithm":"Case rate ($11,464.54). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $9,619.18 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount. Final payment is multiplied by 102%.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Benefit Plan 12507,12508,12509,12521,12522 102% Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICARE REPLACEMENT PLAN [1250]","plan_name":"UHC DUAL COMPLETE SNP MO [12522]","standard_charge_dollar":11693.83,"standard_charge_algorithm":"Case rate ($11,464.54). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $9,619.18 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount. Final payment is multiplied by 102%.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Benefit Plan 12507,12508,12509,12521,12522 102% Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICARE REPLACEMENT PLAN [1250]","plan_name":"UHC MEDICARE COMPLETE AARP [12509]","standard_charge_dollar":11693.83,"standard_charge_algorithm":"Case rate ($11,464.54). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $9,619.18 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount. Final payment is multiplied by 102%.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Benefit Plan 12507,12508,12509,12521,12522 102% Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICARE REPLACEMENT PLAN [1250]","plan_name":"UHC MEDICARE GOLD SILVER OR CHOICE [12507]","standard_charge_dollar":11693.83,"standard_charge_algorithm":"Case rate ($11,464.54). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $9,619.18 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount. Final payment is multiplied by 102%.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Benefit Plan 12507,12508,12509,12521,12522 102% Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":1696.00,"standard_charge_algorithm":"Per diem ($1,696).","count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay. Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"HUMANA COMMERCIAL TRANSPLANT [57515]","standard_charge_dollar":12706.64,"standard_charge_algorithm":"Case rate ($12,706.64). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $10,861.29 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"OPTUM COMMERCIAL HEART TX [57521]","standard_charge_dollar":12706.64,"standard_charge_algorithm":"Case rate ($12,706.64). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $10,861.29 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"OPTUM MA HEART TX [57519]","standard_charge_dollar":12706.64,"standard_charge_algorithm":"Case rate ($12,706.64). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $10,861.29 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"PRETRANSPLANT [57510]","standard_charge_dollar":12706.64,"standard_charge_algorithm":"Case rate ($12,706.64). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $10,861.29 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT CASE RATE [57508]","standard_charge_dollar":12706.64,"standard_charge_algorithm":"Case rate ($12,706.64). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $10,861.29 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT SINGLE CASE AGREEMENT [57507]","standard_charge_dollar":12706.64,"standard_charge_algorithm":"Case rate ($12,706.64). If operating cost, defined as billed amount less exclusions * an operating cost-to-charge ratio of 0.19, exceeds $11,819.08, add-ons for qualifying new technology services are included. If operating cost exceeds $50,185.50 plus the cost of any qualifying new technology services, the stay qualifies for an operating outlier of 80% of the excess amount. If capital cost, defined as billed amount less exclusions * a capital cost-to-charge ratio of 0.006, exceeds $2,034.52, the stay qualifies for a capital outlier of 80% of the excess amount. For transfer cases, the transfer adjustment factor is defined as (length of stay + 1) \/ 6.5. The base transfer operating payment is the transfer adjustment factor * $10,861.29 + an uncompensated DSH payment of $1,019.66. The transfer operating threshold is the transfer adjustment factor * $10,799.42 + an uncompensated DSH payment of $1,019.66. If operating cost exceeds the transfer operating threshold, add-ons for qualifying new technology services are included. If operating cost exceeds the transfer operating threshold + the cost of any qualifying new technology services, the stay qualifies for a transfer operating outlier of 80% of the excess amount. The base transfer capital payment is the transfer adjustment factor * $825.70. The transfer capital threshold is the transfer adjustment factor * $825.70. If the capital cost exceeds the transfer capital threshold, the stay qualifies for a transfer capital outlier of 80% of the excess amount.","count":"0","methodology":"other","additional_payer_notes":"Acute Care DRGs Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":1582.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":1582.00,"count":"0","methodology":"per diem","additional_payer_notes":"Estimated amount calculated based on 3 day length of stay."}]}]},{"description":"PSYLLIUM HUSK 3.4 GRAM ORAL POWDER PACKET","drug_information":{"unit":1.00,"type":"UN"},"code_information":[{"code":"0250","type":"RC"},{"code":"0637","type":"RC"},{"code":"37000-0024-04","type":"NDC"},{"code":"37000-0024-10","type":"NDC"},{"code":"37000-0254-45","type":"NDC"},{"code":"37000-0741-08","type":"NDC"},{"code":"A9270","type":"HCPCS"},{"code":"RX-11218","type":"CDM"}],"standard_charges":[{"gross_charge":7.05,"discounted_cash":4.23,"minimum":1.76,"maximum":7.05,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":5.99,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":6.70,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":4.75,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":5.99,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":4.75,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":4.75,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":4.75,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":4.75,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":3.86,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":4.39,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":4.39,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":4.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":4.39,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":4.43,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":3.73,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":4.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":4.22,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":4.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":4.39,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.22,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":4.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.72,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.31,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.48,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.94,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.64,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.40,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.53,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.76,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.29,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.18,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.18,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.18,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.18,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.18,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.61,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.04,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.75,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":8.05,"discounted_cash":4.83,"minimum":1.76,"maximum":8.05,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":6.84,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":7.65,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":5.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":6.84,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":5.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":5.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":5.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":4.81,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":5.39,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":5.39,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":5.23,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":5.23,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":5.23,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.93,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":5.23,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.97,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":5.64,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":6.44,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.74,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":4.03,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":8.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":2.01,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":6.04,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":8.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":8.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":8.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":8.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":8.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":5.42,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":8.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":8.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":8.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":9.10,"discounted_cash":5.46,"minimum":1.76,"maximum":8.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":7.74,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":6.13,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":6.13,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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[40018]","standard_charge_dollar":5.67,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":5.71,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":4.81,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":5.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":5.57,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":5.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":3.09,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":4.55,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":9.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":9.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":9.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":9.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":11.90,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":12.64,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":9.59,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":9.73,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":19.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.86,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":14.59,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":19.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":11.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE 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[8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":12.80,"discounted_cash":7.68,"minimum":1.75,"maximum":12.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.31,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.96,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":10.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.35,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.40,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.20,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.60,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":12.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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[50006]","standard_charge_dollar":7.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":7.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":7.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":6.43,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":7.20,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":7.20,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":6.99,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":6.99,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":6.99,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":6.58,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":6.99,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":5.30,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":7.53,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":8.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":3.66,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":8.06,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":10.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":6.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":6.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":6.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":6.37,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":10.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":10.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":10.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":10.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":7.24,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":10.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":10.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":10.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":16.80,"discounted_cash":10.08,"minimum":2.69,"maximum":16.80,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":14.28,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":11.31,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":11.31,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":11.26,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":10.05,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":11.26,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":10.47,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":10.05,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":11.26,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":11.26,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":10.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":10.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":10.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":8.28,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":11.76,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":13.44,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.71,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.40,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":16.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.20,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":12.60,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":16.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.87,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":16.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":16.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":16.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":16.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":11.31,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":16.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":16.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":16.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[50005]","standard_charge_dollar":11.88,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":15.00,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":11.88,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":11.83,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":11.83,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":11.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":11.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":11.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":10.80,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":11.47,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":8.70,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":12.36,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":14.12,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":6.00,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":8.83,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":17.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":4.41,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":13.24,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":17.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":10.46,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":10.46,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":17.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":17.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":17.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":11.88,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":17.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":17.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[50006]","standard_charge_dollar":19.25,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":19.25,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":19.25,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":17.50,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":18.59,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":14.10,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final 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BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":4.58,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":2.03,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"RISPERIDONE 0.5 MG DISINTEGRATING 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the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":21.34,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":21.34,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":21.34,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":17.35,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":19.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":19.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":16.77,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":21.24,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":18.96,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":21.24,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":19.75,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":18.96,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":21.24,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":21.24,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":20.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":20.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":20.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":19.40,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":20.61,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":15.63,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":22.19,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":7.89,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":8.39,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":6.36,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":9.03,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":10.32,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.39,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.45,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.23,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.68,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":12.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.65,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.65,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.65,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":7.65,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH 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the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":12.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":12.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":12.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":12.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.68,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":12.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":12.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":12.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":15.60,"discounted_cash":9.36,"minimum":3.23,"maximum":14.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":13.26,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":10.50,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":10.50,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":10.50,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":10.50,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":8.54,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":9.72,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":9.72,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":10.45,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":9.72,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":9.80,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":8.25,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":10.45,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":9.33,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":10.45,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":9.72,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":9.33,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":10.45,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":10.45,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":10.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":10.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":10.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":9.55,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":10.14,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":7.69,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":10.92,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":12.48,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":5.30,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":7.80,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":15.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.90,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":11.70,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":15.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":9.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":9.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":9.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":9.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":9.25,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":10.20,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":4.52,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":15.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":15.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":15.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":15.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":10.50,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":50.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":50.90,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":47.92,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":62.64,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":26.62,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":39.15,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":78.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":19.58,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":58.73,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":78.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":46.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":46.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":78.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":78.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":78.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":7.80,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":5.92,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":8.40,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":9.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":4.08,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":6.00,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":3.00,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":9.00,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":7.11,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":8.08,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":12.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[50014]","standard_charge_dollar":5.95,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":4.69,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"SKIN CLEANSER COMBINATION NO.42","drug_information":{"unit":118.00,"type":"ML"},"code_information":[{"code":"00299-0110-24","type":"NDC"},{"code":"0250","type":"RC"},{"code":"0637","type":"RC"},{"code":"A9270","type":"HCPCS"},{"code":"RX-200485","type":"CDM"}],"standard_charges":[{"gross_charge":30.65,"discounted_cash":18.39,"minimum":7.66,"maximum":29.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":19.09,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":18.33,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":20.54,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":20.54,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":19.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":19.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":19.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":18.76,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":19.92,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":15.11,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":21.46,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":24.52,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":10.42,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":15.33,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":30.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.66,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":22.99,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":30.65,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":21.97,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":21.97,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":20.69,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":33.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":8.45,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":25.35,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":33.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":20.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":20.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":33.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":33.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":33.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":103.33,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":115.78,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":115.78,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":105.75,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":112.32,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":85.19,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":86.40,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":172.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":43.20,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":129.60,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":172.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":102.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":102.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":102.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":102.44,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":172.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":116.33,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":172.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[50002]","standard_charge_dollar":128.85,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":128.85,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":104.73,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL 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[4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":128.24,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":114.46,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":128.24,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":128.24,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":124.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":124.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":124.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":117.14,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":124.41,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service 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15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":65.08,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":95.70,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":191.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":47.85,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":143.55,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":191.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":113.46,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":113.46,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":113.46,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":113.46,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":113.46,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":125.12,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":55.51,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":191.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":191.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":191.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":191.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":191.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of 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[50005]","standard_charge_dollar":129.73,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":163.80,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":129.73,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":129.11,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":120.05,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":115.23,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":129.11,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":129.11,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":125.26,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":125.26,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":125.26,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":117.93,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":23.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":5.90,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":17.70,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed 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payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":24.23,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":17.17,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":21.68,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":17.17,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":17.17,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":17.17,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":15.25,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":17.09,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":17.09,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":16.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":16.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":16.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":15.61,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":16.58,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":12.57,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":17.85,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":20.40,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":8.67,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":12.75,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":25.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":6.38,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":19.13,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":25.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":15.12,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":15.12,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":15.12,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":15.12,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":15.12,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":16.67,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":7.40,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":25.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":25.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":25.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final 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charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":25.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":25.50,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":28.30,"discounted_cash":16.98,"minimum":5.90,"maximum":28.30,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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OF KS EXCHANGE HMO [40026]","standard_charge_dollar":18.96,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":16.92,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":18.96,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":17.63,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":16.92,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":18.96,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":18.40,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":17.32,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":18.40,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":13.95,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":19.81,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":22.64,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":28.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":28.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":28.30,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":21.71,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":21.71,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":20.44,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":33.40,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":8.35,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":25.05,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":15.41,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":21.88,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":25.00,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":10.63,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":15.63,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":31.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":7.81,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":23.44,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":31.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":9.06,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":31.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":31.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":31.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":31.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":21.04,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":31.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":31.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":31.25,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":22.85,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":21.24,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":20.39,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":22.85,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":22.85,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":22.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":22.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":22.17,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":20.87,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":27.28,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":11.59,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":17.05,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":34.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":8.53,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":25.58,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":34.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":20.21,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":20.21,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":34.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":34.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":34.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":22.96,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":34.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":34.10,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":17.10,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":34.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":8.55,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":25.65,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":34.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":20.27,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":20.27,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":20.27,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":20.27,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":20.27,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":22.36,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":9.92,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":33.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":22.45,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":33.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":38.99,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":37.83,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":37.83,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":37.83,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":35.62,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":37.83,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":28.69,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":40.74,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":46.56,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":19.79,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":29.10,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":14.55,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":43.65,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":34.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":34.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":34.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":34.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":34.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":38.05,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":16.88,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":39.18,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":58.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":39.46,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":36.69,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":35.22,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":39.46,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":39.46,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":38.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":38.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":38.29,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":36.05,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":47.12,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":20.03,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":29.45,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":58.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":14.73,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":44.18,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":58.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":34.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":34.92,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":58.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":58.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":58.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":36.48,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":40.87,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":38.00,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":37.33,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":39.65,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":30.07,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":30.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":61.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":15.25,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":45.75,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":61.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":36.16,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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[4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":15.64,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":17.52,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":17.52,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":16.00,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":17.00,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":12.89,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":18.31,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":20.92,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":8.89,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":13.08,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":26.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":6.54,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":19.61,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":26.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":15.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":15.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":15.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":15.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":15.50,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":17.09,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":7.58,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":26.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":26.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":26.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":26.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":17.60,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":26.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":26.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":26.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":41.20,"discounted_cash":24.72,"minimum":2.96,"maximum":39.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":35.02,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":27.74,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":27.74,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":27.74,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":27.74,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":22.54,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":25.67,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":25.67,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":27.60,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":25.67,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":25.87,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":21.79,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":27.60,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":24.64,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":27.60,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":25.67,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":24.64,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":27.60,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":27.60,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":26.78,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":26.78,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":26.78,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":25.21,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":26.78,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":20.31,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":28.84,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":32.96,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":14.01,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":20.60,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":41.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":10.30,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":30.90,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":41.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":24.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":24.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":24.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":24.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":24.42,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":26.93,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":11.95,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":41.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":41.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":41.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":41.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":27.74,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":41.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":41.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":41.20,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":2.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":3.50,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":1.75,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":5.25,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":4.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":4.71,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":7.00,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":13.36,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":12.83,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":14.37,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":13.94,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":13.13,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":13.94,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months 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posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":7.29,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":10.73,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":21.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":5.36,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":16.09,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":21.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":6.22,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":21.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":21.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":21.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":21.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":21.45,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[50005]","standard_charge_dollar":34.94,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":44.12,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":34.94,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":33.74,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":25.59,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":36.33,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":41.52,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":17.65,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":25.95,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":51.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":12.98,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":38.93,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":51.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":30.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":30.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":30.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":30.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":30.77,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":33.93,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":15.05,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":51.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":51.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":51.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":51.90,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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[4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":138.59,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":155.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":144.38,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":138.59,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":155.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":155.27,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":150.64,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":150.64,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":150.64,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":141.83,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":150.64,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":114.25,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":162.23,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":185.40,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":78.80,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":115.88,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":231.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":57.94,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":173.81,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":231.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":137.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":137.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":137.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":137.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":137.38,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":151.49,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":67.21,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":231.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":231.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":231.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":231.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":156.01,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":231.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":231.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":231.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]},{"description":"VILOXAZINE ER 100 MG CAPSULE EXTENDED RELEASE 24 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file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":161.43,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":203.83,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":161.43,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":161.43,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":161.43,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":161.43,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":131.22,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":149.40,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":149.40,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":160.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":149.40,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":143.40,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":160.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":160.67,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":155.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":155.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":155.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":146.76,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":155.87,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":118.22,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":167.86,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":191.84,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":81.53,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":119.90,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":239.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":59.95,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":179.85,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":239.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":142.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":142.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":142.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":142.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":142.15,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":29.98,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":29.98,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":29.09,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":29.09,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":29.09,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":27.39,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":29.09,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":22.06,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":31.33,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":35.80,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":15.22,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":22.38,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":44.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":11.19,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":33.56,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":44.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":26.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":26.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":26.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":26.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":26.53,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":29.25,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":12.98,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":44.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":44.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":44.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":44.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":30.13,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":44.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":44.75,"standard_charge_percentage":100.00,"count":"0","methodology":"percent 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[40033]","standard_charge_dollar":33.67,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":36.21,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":33.67,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":32.32,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":36.21,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":33.67,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":32.32,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":36.21,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":36.21,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":33.08,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":35.13,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":26.65,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":37.84,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":43.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":18.38,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":27.03,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":54.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":13.51,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":40.54,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":54.05,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":32.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":32.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":32.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":32.04,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":16.18,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":15.05,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":14.44,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":16.18,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":16.18,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":15.70,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":15.70,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":15.70,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":14.78,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":15.70,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":11.91,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":16.91,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":19.32,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":8.21,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":12.08,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":24.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":6.04,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":18.11,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":24.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":14.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":14.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":14.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":14.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":14.32,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":15.79,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":7.00,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":24.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":24.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":24.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":24.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":16.26,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":24.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":24.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":24.15,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":72.55,"discounted_cash":43.53,"minimum":6.04,"maximum":68.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":61.67,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":68.92,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":48.84,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":61.67,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":48.84,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":48.84,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":48.84,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":48.84,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":39.70,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":45.20,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":45.20,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE [40017]","standard_charge_dollar":48.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE [40018]","standard_charge_dollar":45.20,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":43.38,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":48.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":45.20,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":43.38,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":48.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":48.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":47.16,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":47.16,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":47.16,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":44.40,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":47.16,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":35.77,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":50.79,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":58.04,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":24.67,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":36.28,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":72.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":18.14,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":54.41,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":72.55,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":43.01,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":4.28,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":4.55,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":3.45,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":4.90,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":5.60,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":13.01,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":17.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":10.29,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to 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service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":17.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":17.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":17.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":17.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":11.68,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":17.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":17.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":17.35,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":52.80,"discounted_cash":31.68,"minimum":4.34,"maximum":52.80,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":44.88,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":35.54,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":35.54,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":35.38,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":34.32,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":34.32,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":34.32,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":32.31,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":34.32,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":26.03,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":36.96,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":42.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":17.95,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":26.40,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":52.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":13.20,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":39.60,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":52.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":31.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":31.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":31.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":31.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":31.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":34.52,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 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final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":52.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":52.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":52.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":366.84,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":464.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":414.68,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in 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to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":525.80,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":665.95,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":594.38,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":665.95,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":619.23,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":594.38,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the 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the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":646.07,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":646.07,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":646.07,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed 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CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":11.62,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":11.28,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":11.28,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":34.32,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":34.32,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":34.32,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":32.31,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":34.32,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":26.03,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":36.96,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":42.24,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":17.95,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":26.40,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":52.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":13.20,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":39.60,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":52.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":31.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":31.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":31.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":31.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":31.30,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":34.52,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":15.31,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or 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payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":52.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":35.54,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":52.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":52.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":52.80,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":91.95,"discounted_cash":55.17,"minimum":4.34,"maximum":87.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP 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[50014]","standard_charge_dollar":78.16,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":61.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":61.90,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 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[4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":57.28,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":54.99,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":61.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":61.61,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":59.77,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":59.77,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":59.77,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":56.27,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":59.77,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":45.33,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":64.37,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":73.56,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":31.26,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":45.98,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":91.95,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the 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[40018]","standard_charge_dollar":6.60,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE BLUE EXCHANGE [40016]","standard_charge_dollar":6.66,"standard_charge_percentage":62.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC UCM KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":5.61,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":7.10,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":6.34,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":7.10,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":6.60,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":6.34,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":7.10,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":7.10,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":6.89,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":6.89,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":6.89,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":6.49,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":6.89,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":5.23,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":7.42,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":8.48,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":3.60,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":5.30,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":10.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":2.65,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":7.95,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":10.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":6.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":6.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":6.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":6.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":6.28,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":6.93,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":3.07,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":10.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":10.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":10.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":10.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":7.14,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":10.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":10.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":10.60,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]},{"gross_charge":10.70,"discounted_cash":6.42,"minimum":1.75,"maximum":10.00,"setting":"both","payers_information":[{"payer_name":"AETNA [5000]","plan_name":"AETNA I35 MERITAIN NAP [50018]","standard_charge_dollar":9.10,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA INDEMNITY [50009]","standard_charge_dollar":10.17,"standard_charge_percentage":95.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA LOCAL [50005]","standard_charge_dollar":7.20,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NAP [50014]","standard_charge_dollar":9.10,"standard_charge_percentage":85.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA NATIONAL [50006]","standard_charge_dollar":7.20,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURE MISC PPO [50010]","standard_charge_dollar":7.20,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2905 [50002]","standard_charge_dollar":7.20,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"AETNA SIGNATURES LUMINARE POB 2920 [50000]","standard_charge_dollar":7.20,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"AETNA [5000]","plan_name":"ZZZAETNA CARELINK EXCHANGE [50016]","standard_charge_dollar":5.86,"standard_charge_percentage":54.72,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC FEDERAL [40012]","standard_charge_dollar":6.67,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC HPN [40033]","standard_charge_dollar":6.67,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC KC PREFERRED CARE 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KCMO BLUE SELECT PLUS [40029]","standard_charge_dollar":5.66,"standard_charge_percentage":52.90,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OF KS EXCHANGE HMO [40026]","standard_charge_dollar":7.17,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA BLUE SELECT PLUS [40032]","standard_charge_dollar":6.40,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE [40010]","standard_charge_dollar":7.17,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA PREF CARE BLUE PPO [40011]","standard_charge_dollar":6.67,"standard_charge_percentage":62.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"BC OUT OF AREA TRADITIONAL [40009]","standard_charge_dollar":6.40,"standard_charge_percentage":59.80,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK HEALTHLINK [40019]","standard_charge_dollar":7.17,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK PHP [40002]","standard_charge_dollar":7.17,"standard_charge_percentage":67.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT [40021]","standard_charge_dollar":6.96,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT HEALTHLINK PPO [40020]","standard_charge_dollar":6.96,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"FREEDOM NETWORK SELECT PHP [40001]","standard_charge_dollar":6.96,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZBC PREFERRED CARE BLUE SLHS [40027]","standard_charge_dollar":6.55,"standard_charge_percentage":61.20,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"BLUE CROSS BLUE SHIELD [4000]","plan_name":"ZZZFREEDOM NETWORK SELECT CERNER [40000]","standard_charge_dollar":6.96,"standard_charge_percentage":65.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA BJC FLEX OR HDHP [70017]","standard_charge_dollar":5.28,"standard_charge_percentage":49.30,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"CIGNA INDEMNITY [70004]","standard_charge_dollar":7.49,"standard_charge_percentage":70.00,"standard_charge_algorithm":"70% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"EVERNORTH BEHAVIORAL HEALTH [70007]","standard_charge_dollar":8.56,"standard_charge_percentage":80.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"CIGNA [7000]","plan_name":"ZZZCIGNA BJC [70010]","standard_charge_dollar":3.64,"standard_charge_percentage":34.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"CARELON BEHAVIORAL HEALTH [80000]","standard_charge_dollar":5.35,"standard_charge_percentage":50.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"HEALTHLINK HMO [80009]","standard_charge_dollar":10.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"MEDICA EXCHANGE [80075]","standard_charge_dollar":2.68,"standard_charge_percentage":25.00,"standard_charge_algorithm":"25% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PHCS MULTIPLAN [80056]","standard_charge_dollar":8.03,"standard_charge_percentage":75.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"COMMERCIAL-CONTRACTED [8000]","plan_name":"PROVIDRS CARE NETWORK [80021]","standard_charge_dollar":10.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MEDISHARE [55122]","standard_charge_dollar":6.34,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH MISC [55116]","standard_charge_dollar":6.34,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH REPRICING ADDRS [55113]","standard_charge_dollar":6.34,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"FIRST HEALTH UPREHS [55119]","standard_charge_dollar":6.34,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"FIRST HEALTH [5512]","plan_name":"ZZZFIRST HEALTH BENEFIT MANAGEMENT [55117]","standard_charge_dollar":6.34,"standard_charge_percentage":59.28,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"HUMANA [7500]","plan_name":"ZZZHUMANA COMMERCIAL PPO POS [75001]","standard_charge_dollar":6.99,"standard_charge_percentage":65.37,"standard_charge_algorithm":"65.37% of billed.","count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HEALTHY BLUE MISSOURI [22572]","standard_charge_dollar":3.10,"standard_charge_percentage":29.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE BEHAVIORAL HEALTH [22504]","standard_charge_dollar":10.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"HOME STATE HEALTH PLAN [22506]","standard_charge_dollar":10.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE (MO) [2250]","plan_name":"UHC COMMUNITY PLAN OF MO [22517]","standard_charge_dollar":10.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"MEDICAID MANAGED CARE OTHER [2257]","plan_name":"HOME STATE BEHAVIORAL HEALTH SMHK [22575]","standard_charge_dollar":10.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"AETNA COMMERCIAL E&P TRANSPLANT [57517]","standard_charge_dollar":7.20,"standard_charge_percentage":67.32,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"TRANSPLANTS-CASE RATES [5750]","plan_name":"TRANSPLANT MO HEALTHNET [57513]","standard_charge_dollar":10.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"UNITED BEHAVIORAL HEALTH SYSTEM [30011]","standard_charge_dollar":10.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."},{"payer_name":"UNITED HEALTHCARE [3000]","plan_name":"ZZZUHC SLHS UMR CHOICE PLUS [30021]","standard_charge_dollar":10.70,"standard_charge_percentage":100.00,"count":"0","methodology":"percent of total billed charges","additional_payer_notes":"Zero final payments for the item or service in the 15 months prior to posting the file."}]}]}]}