{"hospital_name":"West Chester Hospital, LLC","last_updated_on":"2026-04-01","version":"3.0.0","location_name":["West Chester Hospital, LLC"],"hospital_address":["7700 University Drive, West Chester, OH 45069"],"license_information":{"license_number":"N/A","state":"OH"},"type_2_npi":["1851549273"],"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":"Adam Niemann"},"financial_aid_policy":["40% off of facility standard gross charges."],"modifier_information":[{"description":"Clia waived test","code":"QW","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Aetna Rental Network - NAB/First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Cincinnati Preferred Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"AmeriHealth","plan_name":"Caritas Ohio Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Center Care","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO/POS","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cincinnati Public Library","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"CommuniCare Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cronin Automotive","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Great Parks of Hamilton County","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Green Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Health Ohio Network","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Madtree Brewing","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan Health","plan_name":"Aerospace All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MDWise","plan_name":"Hoosier Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"NAS Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"SuperMed/CORE HMO/POS/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Valley Goodwill","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Paramount","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Skilled Care Pharmacy","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Springfield Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Stock Material Handling Systems","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UC Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"USA MCO","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Watson Gravel","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Reduced Services","code":"52","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Aetna Rental Network - NAB/First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Cincinnati Preferred Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"AmeriHealth","plan_name":"Caritas Ohio Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Center Care","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO/POS","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cincinnati Public Library","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"CommuniCare Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cronin Automotive","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Great Parks of Hamilton County","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Green Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Health Ohio Network","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Madtree Brewing","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan Health","plan_name":"Aerospace All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MDWise","plan_name":"Hoosier Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"NAS Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"SuperMed/CORE HMO/POS/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Valley Goodwill","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Paramount","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Skilled Care Pharmacy","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Springfield Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Stock Material Handling Systems","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UC Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"USA MCO","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Watson Gravel","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Bilateral Procedure","code":"50","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Aetna Rental Network - NAB/First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Cincinnati Preferred Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"AmeriHealth","plan_name":"Caritas Ohio Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Center Care","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO/POS","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cincinnati Public Library","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"CommuniCare Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cronin Automotive","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Great Parks of Hamilton County","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Green Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Health Ohio Network","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Madtree Brewing","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan Health","plan_name":"Aerospace All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MDWise","plan_name":"Hoosier Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"NAS Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"SuperMed/CORE HMO/POS/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Valley Goodwill","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Paramount","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Skilled Care Pharmacy","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Springfield Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Stock Material Handling Systems","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UC Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"USA MCO","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Watson Gravel","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Services delivered under an outpatient physical therapy plan of care","code":"GP","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Aetna Rental Network - NAB/First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Cincinnati Preferred Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"AmeriHealth","plan_name":"Caritas Ohio Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Center Care","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO/POS","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cincinnati Public Library","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"CommuniCare Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cronin Automotive","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Great Parks of Hamilton County","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Green Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Health Ohio Network","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Madtree Brewing","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan Health","plan_name":"Aerospace All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MDWise","plan_name":"Hoosier Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"NAS Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"SuperMed/CORE HMO/POS/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Valley Goodwill","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Paramount","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Skilled Care Pharmacy","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Springfield Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Stock Material Handling Systems","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UC Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"USA MCO","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Watson Gravel","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Services delivered under an outpatient occupational therapy plan of care","code":"GO","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Aetna Rental Network - NAB/First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Cincinnati Preferred Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"AmeriHealth","plan_name":"Caritas Ohio Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Center Care","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO/POS","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cincinnati Public Library","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"CommuniCare Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cronin Automotive","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Great Parks of Hamilton County","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Green Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Health Ohio Network","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Madtree Brewing","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan Health","plan_name":"Aerospace All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MDWise","plan_name":"Hoosier Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"NAS Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"SuperMed/CORE HMO/POS/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Valley Goodwill","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Paramount","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Skilled Care Pharmacy","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Springfield Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Stock Material Handling Systems","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UC Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"USA MCO","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Watson Gravel","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Services delivered under an outpatient speech language pathology plan of care","code":"GN","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Aetna Rental Network - NAB/First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Cincinnati Preferred Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"AmeriHealth","plan_name":"Caritas Ohio Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Center Care","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO/POS","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cincinnati Public Library","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"CommuniCare Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cronin Automotive","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Great Parks of Hamilton County","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Green Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Health Ohio Network","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Madtree Brewing","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan Health","plan_name":"Aerospace All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MDWise","plan_name":"Hoosier Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"NAS Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"SuperMed/CORE HMO/POS/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Valley Goodwill","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Paramount","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Skilled Care Pharmacy","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Springfield Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Stock Material Handling Systems","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UC Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"USA MCO","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Watson Gravel","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"State supplied vaccine","code":"SL","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Aetna Rental Network - NAB/First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Cincinnati Preferred Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"AmeriHealth","plan_name":"Caritas Ohio Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Center Care","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO/POS","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cincinnati Public Library","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"CommuniCare Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cronin Automotive","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Great Parks of Hamilton County","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Green Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Health Ohio Network","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Madtree Brewing","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan Health","plan_name":"Aerospace All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MDWise","plan_name":"Hoosier Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"NAS Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"SuperMed/CORE HMO/POS/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Valley Goodwill","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Paramount","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Skilled Care Pharmacy","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Springfield Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Stock Material Handling Systems","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UC Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"USA MCO","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Watson Gravel","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Mental health program","code":"HE","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Aetna Rental Network - NAB/First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Cincinnati Preferred Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"AmeriHealth","plan_name":"Caritas Ohio Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Center Care","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO/POS","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cincinnati Public Library","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"CommuniCare Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cronin Automotive","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Great Parks of Hamilton County","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Green Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Health Ohio Network","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Madtree Brewing","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan Health","plan_name":"Aerospace All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MDWise","plan_name":"Hoosier Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"NAS Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"SuperMed/CORE HMO/POS/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Valley Goodwill","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Paramount","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Skilled Care Pharmacy","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Springfield Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Stock Material Handling Systems","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UC Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"USA MCO","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Watson Gravel","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Clinical social worker","code":"AJ","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Aetna Rental Network - NAB/First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Cincinnati Preferred Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"AmeriHealth","plan_name":"Caritas Ohio Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Center Care","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO/POS","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cincinnati Public Library","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"CommuniCare Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cronin Automotive","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Great Parks of Hamilton County","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Green Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Health Ohio Network","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Madtree Brewing","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan Health","plan_name":"Aerospace All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MDWise","plan_name":"Hoosier Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"NAS Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"SuperMed/CORE HMO/POS/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Valley Goodwill","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Paramount","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Skilled Care Pharmacy","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Springfield Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Stock Material Handling Systems","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UC Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"USA MCO","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Watson Gravel","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Medicaid level of care 3, as defined by each state","code":"U3","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Aetna Rental Network - NAB/First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Cincinnati Preferred Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"AmeriHealth","plan_name":"Caritas Ohio Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Center Care","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO/POS","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cincinnati Public Library","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"CommuniCare Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cronin Automotive","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Great Parks of Hamilton County","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Green Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Health Ohio Network","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Madtree Brewing","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan Health","plan_name":"Aerospace All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MDWise","plan_name":"Hoosier Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"NAS Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"SuperMed/CORE HMO/POS/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Valley Goodwill","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Oscar","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Paramount","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Perennial Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Skilled Care Pharmacy","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Springfield Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Stock Material Handling Systems","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UC Health","plan_name":"Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"UnitedHealthCare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"USA MCO","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Watson Gravel","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Wellcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."}]},{"description":"Technical Component; represents the costs of equipment, supplies, and technician personnel for a procedure, excluding the physician's interpretation. It is used when only the technical portion of a test is billed, typically by hospitals, imaging centers, or independent diagnostic testing facilities","code":"TC","modifier_payer_information":[{"payer_name":"Aetna","plan_name":"Aetna Rental Network - NAB/First Health All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"ASA Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Cincinnati Preferred Other Commercial Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Aetna","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"AmeriHealth","plan_name":"Caritas Ohio Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem HMO/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Pathway Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"BCBS","plan_name":"Anthem Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Ambetter Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Buckeye Health Plan","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"CareSource","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Center Care","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"HMO/POS","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cigna","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cincinnati Public Library","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"CommuniCare Advantage","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Cronin Automotive","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Devoted Health","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Great Parks of Hamilton County","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Green Township","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Health Ohio Network","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Humana","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Madtree Brewing","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"Magellan Health","plan_name":"Aerospace All Commercial Plans","description":"The modified price is presented in the standard charge value."},{"payer_name":"MDWise","plan_name":"Hoosier Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"NAS Traditional","description":"The modified price is presented in the standard charge value."},{"payer_name":"Medical Mutual","plan_name":"SuperMed/CORE HMO/POS/PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Dual Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Exchange","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicaid Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Molina Healthcare","plan_name":"Medicare Managed Care Plan","description":"The modified price is presented in the standard charge value."},{"payer_name":"Multiplan","plan_name":"PPO","description":"The modified price is presented in the standard charge value."},{"payer_name":"Ohio Health Choice","plan_name":"All Commercial Plans","description":"The modified price is presented in the standard 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Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_01671406301","type":"CDM"},{"code":"250","type":"RC"},{"code":"01671406301","type":"NDC"}],"standard_charges":[{"gross_charge":3.08,"discounted_cash":1.85,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not 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Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_01671408210","type":"CDM"},{"code":"250","type":"RC"},{"code":"01671408210","type":"NDC"}],"standard_charges":[{"gross_charge":2.71,"discounted_cash":1.63,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_01671408310","type":"CDM"},{"code":"637","type":"RC"},{"code":"01671408310","type":"NDC"}],"standard_charges":[{"gross_charge":2.92,"discounted_cash":1.75,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply 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is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_01671416601","type":"CDM"},{"code":"250","type":"RC"},{"code":"01671416601","type":"NDC"}],"standard_charges":[{"gross_charge":3.4,"discounted_cash":2.04,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_01671416701","type":"CDM"},{"code":"250","type":"RC"},{"code":"01671416701","type":"NDC"}],"standard_charges":[{"gross_charge":3.42,"discounted_cash":2.05,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_01671417101","type":"CDM"},{"code":"250","type":"RC"},{"code":"01671417101","type":"NDC"}],"standard_charges":[{"gross_charge":2.85,"discounted_cash":1.71,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_01671417201","type":"CDM"},{"code":"637","type":"RC"},{"code":"01671417201","type":"NDC"}],"standard_charges":[{"gross_charge":3.27,"discounted_cash":1.96,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 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NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_01671418403","type":"CDM"},{"code":"637","type":"RC"},{"code":"01671418403","type":"NDC"}],"standard_charges":[{"gross_charge":3.76,"discounted_cash":2.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_01671419401","type":"CDM"},{"code":"637","type":"RC"},{"code":"01671419401","type":"NDC"}],"standard_charges":[{"gross_charge":2.49,"discounted_cash":1.49,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 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Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_02315511101","type":"CDM"},{"code":"250","type":"RC"},{"code":"02315511101","type":"NDC"}],"standard_charges":[{"gross_charge":3.25,"discounted_cash":1.95,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_02315519101","type":"CDM"},{"code":"637","type":"RC"},{"code":"02315519101","type":"NDC"}],"standard_charges":[{"gross_charge":3.37,"discounted_cash":2.02,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_02315519201","type":"CDM"},{"code":"250","type":"RC"},{"code":"02315519201","type":"NDC"}],"standard_charges":[{"gross_charge":3.05,"discounted_cash":1.83,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not 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Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_02433813610","type":"CDM"},{"code":"250","type":"RC"},{"code":"02433813610","type":"NDC"}],"standard_charges":[{"gross_charge":69.01,"discounted_cash":41.41,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_02435770106","type":"CDM"},{"code":"250","type":"RC"},{"code":"02435770106","type":"NDC"}],"standard_charges":[{"gross_charge":11.69,"discounted_cash":7.01,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross 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Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_02930014710","type":"CDM"},{"code":"637","type":"RC"},{"code":"02930014710","type":"NDC"}],"standard_charges":[{"gross_charge":3.47,"discounted_cash":2.08,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_02930018901","type":"CDM"},{"code":"250","type":"RC"},{"code":"02930018901","type":"NDC"}],"standard_charges":[{"gross_charge":3.76,"discounted_cash":2.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross 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Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_03172215130","type":"CDM"},{"code":"250","type":"RC"},{"code":"03172215130","type":"NDC"}],"standard_charges":[{"gross_charge":3.36,"discounted_cash":2.02,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_03172215290","type":"CDM"},{"code":"250","type":"RC"},{"code":"03172215290","type":"NDC"}],"standard_charges":[{"gross_charge":3.76,"discounted_cash":2.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_03172215490","type":"CDM"},{"code":"637","type":"RC"},{"code":"03172215490","type":"NDC"}],"standard_charges":[{"gross_charge":3.76,"discounted_cash":2.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_03172219501","type":"CDM"},{"code":"250","type":"RC"},{"code":"03172219501","type":"NDC"}],"standard_charges":[{"gross_charge":3.76,"discounted_cash":2.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_03172224030","type":"CDM"},{"code":"250","type":"RC"},{"code":"03172224030","type":"NDC"}],"standard_charges":[{"gross_charge":2.35,"discounted_cash":1.41,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_03172224130","type":"CDM"},{"code":"250","type":"RC"},{"code":"03172224130","type":"NDC"}],"standard_charges":[{"gross_charge":4.73,"discounted_cash":2.84,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 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Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_03172252001","type":"CDM"},{"code":"637","type":"RC"},{"code":"03172252001","type":"NDC"}],"standard_charges":[{"gross_charge":2.93,"discounted_cash":1.76,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_03172252201","type":"CDM"},{"code":"637","type":"RC"},{"code":"03172252201","type":"NDC"}],"standard_charges":[{"gross_charge":3.76,"discounted_cash":2.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_03172253001","type":"CDM"},{"code":"637","type":"RC"},{"code":"03172253001","type":"NDC"}],"standard_charges":[{"gross_charge":2.88,"discounted_cash":1.73,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_03172253101","type":"CDM"},{"code":"637","type":"RC"},{"code":"03172253101","type":"NDC"}],"standard_charges":[{"gross_charge":2.18,"discounted_cash":1.31,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross 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Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_04778165990","type":"CDM"},{"code":"250","type":"RC"},{"code":"04778165990","type":"NDC"}],"standard_charges":[{"gross_charge":3.76,"discounted_cash":2.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_04778166890","type":"CDM"},{"code":"250","type":"RC"},{"code":"04778166890","type":"NDC"}],"standard_charges":[{"gross_charge":3.64,"discounted_cash":2.18,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 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NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05026853515","type":"CDM"},{"code":"250","type":"RC"},{"code":"05026853515","type":"NDC"}],"standard_charges":[{"gross_charge":3.68,"discounted_cash":2.21,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05026854015","type":"CDM"},{"code":"637","type":"RC"},{"code":"05026854015","type":"NDC"}],"standard_charges":[{"gross_charge":3.34,"discounted_cash":2.0,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 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Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05026859415","type":"CDM"},{"code":"637","type":"RC"},{"code":"05026859415","type":"NDC"}],"standard_charges":[{"gross_charge":2.97,"discounted_cash":1.78,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05026859515","type":"CDM"},{"code":"250","type":"RC"},{"code":"05026859515","type":"NDC"}],"standard_charges":[{"gross_charge":3.76,"discounted_cash":2.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply 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supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05026859915","type":"CDM"},{"code":"250","type":"RC"},{"code":"05026859915","type":"NDC"}],"standard_charges":[{"gross_charge":7.62,"discounted_cash":4.57,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05026860415","type":"CDM"},{"code":"250","type":"RC"},{"code":"05026860415","type":"NDC"}],"standard_charges":[{"gross_charge":3.23,"discounted_cash":1.94,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for 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methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05026863315","type":"CDM"},{"code":"250","type":"RC"},{"code":"05026863315","type":"NDC"}],"standard_charges":[{"gross_charge":2.58,"discounted_cash":1.55,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05026863915","type":"CDM"},{"code":"637","type":"RC"},{"code":"05026863915","type":"NDC"}],"standard_charges":[{"gross_charge":3.76,"discounted_cash":2.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05026864015","type":"CDM"},{"code":"637","type":"RC"},{"code":"05026864015","type":"NDC"}],"standard_charges":[{"gross_charge":2.67,"discounted_cash":1.6,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05026864215","type":"CDM"},{"code":"250","type":"RC"},{"code":"05026864215","type":"NDC"}],"standard_charges":[{"gross_charge":3.32,"discounted_cash":1.99,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on 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Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05723715490","type":"CDM"},{"code":"250","type":"RC"},{"code":"05723715490","type":"NDC"}],"standard_charges":[{"gross_charge":3.76,"discounted_cash":2.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05723715530","type":"CDM"},{"code":"250","type":"RC"},{"code":"05723715530","type":"NDC"}],"standard_charges":[{"gross_charge":3.28,"discounted_cash":1.97,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply 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supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05723717401","type":"CDM"},{"code":"250","type":"RC"},{"code":"05723717401","type":"NDC"}],"standard_charges":[{"gross_charge":2.38,"discounted_cash":1.43,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05723717501","type":"CDM"},{"code":"250","type":"RC"},{"code":"05723717501","type":"NDC"}],"standard_charges":[{"gross_charge":3.1,"discounted_cash":1.86,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05723718090","type":"CDM"},{"code":"250","type":"RC"},{"code":"05723718090","type":"NDC"}],"standard_charges":[{"gross_charge":2.76,"discounted_cash":1.66,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05723718190","type":"CDM"},{"code":"250","type":"RC"},{"code":"05723718190","type":"NDC"}],"standard_charges":[{"gross_charge":2.64,"discounted_cash":1.58,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for 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Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05789618105","type":"CDM"},{"code":"250","type":"RC"},{"code":"05789618105","type":"NDC"}],"standard_charges":[{"gross_charge":5.71,"discounted_cash":3.43,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_05789620401","type":"CDM"},{"code":"637","type":"RC"},{"code":"05789620401","type":"NDC"}],"standard_charges":[{"gross_charge":1.88,"discounted_cash":1.13,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 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Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068745201","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068745201","type":"NDC"}],"standard_charges":[{"gross_charge":43.36,"discounted_cash":26.02,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068745301","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068745301","type":"NDC"}],"standard_charges":[{"gross_charge":2.75,"discounted_cash":1.65,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068745401","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068745401","type":"NDC"}],"standard_charges":[{"gross_charge":2.59,"discounted_cash":1.55,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not 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Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068746501","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068746501","type":"NDC"}],"standard_charges":[{"gross_charge":3.04,"discounted_cash":1.82,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068746801","type":"CDM"},{"code":"637","type":"RC"},{"code":"06068746801","type":"NDC"}],"standard_charges":[{"gross_charge":3.76,"discounted_cash":2.26,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply 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supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068747601","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068747601","type":"NDC"}],"standard_charges":[{"gross_charge":2.35,"discounted_cash":1.41,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068747901","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068747901","type":"NDC"}],"standard_charges":[{"gross_charge":2.03,"discounted_cash":1.22,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for 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billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068748701","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068748701","type":"NDC"}],"standard_charges":[{"gross_charge":3.65,"discounted_cash":2.19,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068748801","type":"CDM"},{"code":"637","type":"RC"},{"code":"06068748801","type":"NDC"}],"standard_charges":[{"gross_charge":3.11,"discounted_cash":1.87,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on 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NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068751901","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068751901","type":"NDC"}],"standard_charges":[{"gross_charge":3.35,"discounted_cash":2.01,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068752311","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068752311","type":"NDC"}],"standard_charges":[{"gross_charge":157.42,"discounted_cash":94.45,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068752483","type":"CDM"},{"code":"637","type":"RC"},{"code":"J7626","type":"HCPCS"},{"code":"06068752483","type":"NDC"}],"standard_charges":[{"gross_charge":31.24,"discounted_cash":18.74,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not 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Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068754011","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068754011","type":"NDC"}],"standard_charges":[{"gross_charge":3.86,"discounted_cash":2.32,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068754101","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068754101","type":"NDC"}],"standard_charges":[{"gross_charge":3.45,"discounted_cash":2.07,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply 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supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068755001","type":"CDM"},{"code":"637","type":"RC"},{"code":"06068755001","type":"NDC"}],"standard_charges":[{"gross_charge":3.69,"discounted_cash":2.21,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06068755211","type":"CDM"},{"code":"250","type":"RC"},{"code":"06068755211","type":"NDC"}],"standard_charges":[{"gross_charge":3.37,"discounted_cash":2.02,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for 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NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06075880105","type":"CDM"},{"code":"250","type":"RC"},{"code":"06075880105","type":"NDC"}],"standard_charges":[{"gross_charge":18.28,"discounted_cash":10.97,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: Fsc 14 | NDC EA = 1 EA | Price is variable based on underlying billing methodology - especially, for drug and supply items."}]},{"description":"NDC Description Not Available","drug_information":{"unit":1.0,"type":"EA"},"code_information":[{"code":"25010001_06075880205","type":"CDM"},{"code":"250","type":"RC"},{"code":"06075880205","type":"NDC"}],"standard_charges":[{"gross_charge":10.02,"discounted_cash":6.01,"setting":"both","billing_class":"facility","additional_generic_notes":"Gross Charge Type: 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