{"hospital_name": "CHRISTUS Health - Palestine", "last_updated_on": "2026-01-30", "version": "3.0.0", "pid": "3243274362", "rid": "2731", "location_name": ["CHRISTUS Health - Palestine"], "hospital_address": ["3201 TX-256 Loop, Palestine, TX 75801"], "type_2_npi": ["1831070507"], "license_information": {"license_number": "100682", "state": "TX"}, "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": "Eric Garrison"}, "standard_charge_information": [{"description": "0.9% NaCl + KCl 20 mEq/L infusion", "drug_information": {"unit": 1000.0, "type": "ML"}, "code_information": [{"code": "J3480", "type": "HCPCS"}, {"code": "11081", "type": "CDM"}, {"code": "0264-7865-00", "type": "NDC"}], "standard_charges": [{"gross_charge": 183.26, "discounted_cash": 36.65, "setting": "outpatient", 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"standard_charges": [{"gross_charge": 24.03, "discounted_cash": 4.81, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "ALPRAZolam (Xanax) tablet 0.125 mg", "drug_information": {"unit": 0.5, "type": "EA"}, "code_information": [{"code": "324", "type": "CDM"}, {"code": "60687-377-11", "type": "NDC"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 6.31, "discounted_cash": 1.26, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "ALPRAZolam (Xanax) tablet 0.125 mg", "drug_information": {"unit": 1.0, "type": "EA"}, "code_information": [{"code": "324", "type": "CDM"}, {"code": "60687-377-11", "type": "NDC"}, {"code": "259", "type": "RC"}], "standard_charges": [{"gross_charge": 12.62, "discounted_cash": 2.52, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "ALPRAZolam (Xanax) tablet 0.25 mg", "drug_information": {"unit": 0.5, "type": "EA"}, "code_information": [{"code": "325", "type": "CDM"}, 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[{"gross_charge": 19184.0, "discounted_cash": 3836.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0418T INTERROGATE CARD MODULJN DEVICE", "code_information": [{"code": "418T", "type": "CPT"}, {"code": "210980", "type": "CDM"}, {"code": "480", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 10.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0627T PERQ NJX ALGC CELL &/PRDCT UNI/BI FLUOR LMBR 1ST", "code_information": [{"code": "627T", "type": "CPT"}, {"code": "263072", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 29357.0, "discounted_cash": 5871.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0795T TRANSCATH INS 2CHMBR LDLS PM CMPL", "code_information": [{"code": "795T", "type": "CPT"}, {"code": "289351", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 34085.0, "discounted_cash": 6817.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0796T TRANSCATH INS 2CHMBR LDLS PM RA", "code_information": [{"code": "796T", "type": "CPT"}, {"code": "289353", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 34085.0, "discounted_cash": 6817.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0797T TRANSCATH INS 2CHMBR LDLS PM RV", "code_information": [{"code": "797T", "type": "CPT"}, {"code": "289355", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 34085.0, "discounted_cash": 6817.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0798T TRANSCATH RMV 2CHMBR LDLS PM CMPL", "code_information": [{"code": "798T", "type": "CPT"}, {"code": "289357", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 6681.0, "discounted_cash": 1336.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0799T TRANSCATH RMVL 2CHMBR LDLS PM RA", "code_information": [{"code": "799T", "type": "CPT"}, {"code": "289359", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 6681.0, "discounted_cash": 1336.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0800T TRANSCATH RMVL 2CHMBR LDLS PM RV", "code_information": [{"code": "800T", "type": "CPT"}, {"code": "289361", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 6681.0, "discounted_cash": 1336.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0801T TRANSCATH RMV&RPL 2CHMBR LDLS PM", "code_information": [{"code": "801T", "type": "CPT"}, {"code": "289363", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 34085.0, "discounted_cash": 6817.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0802T TTRANSCATH RMV&RPL2CHMB LDLS PM RA", "code_information": [{"code": "802T", "type": "CPT"}, {"code": "289365", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 34085.0, "discounted_cash": 6817.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0803T TRANSCATH RMV&RPL2CHMB LDLS PM RV", "code_information": [{"code": "803T", "type": "CPT"}, {"code": "289367", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 34085.0, "discounted_cash": 6817.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0823T TRANSCATH INS 1CHMBR LDLS PM RA", "code_information": [{"code": "823T", "type": "CPT"}, {"code": "299600", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 38988.0, "discounted_cash": 7797.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0913T PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART", "code_information": [{"code": "913T", "type": "CPT"}, {"code": "342737", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 29032.0, "discounted_cash": 5806.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 0914T PRQ TCAT THR RX NTRC BAL SEP", "code_information": [{"code": "914T", "type": "CPT"}, {"code": "342739", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 3006.0, "discounted_cash": 601.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10004 FINE NDL ASP BX W/O IMG GDE; EA ADD'L LESION", "code_information": [{"code": "10004", "type": "CPT"}, {"code": "200030", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 75.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10005 FINE NDL ASP BX W/ US GDE; 1ST LESION", "code_information": [{"code": "10005", "type": "CPT"}, {"code": "200001", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 841.0, "discounted_cash": 168.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10006 FINE NDL ASP BX W/ US GDE; EA ADD'L LESION", "code_information": [{"code": "10006", "type": "CPT"}, {"code": "200003", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 421.0, "discounted_cash": 84.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10007 FINE NDL ASP BX W/ FLUORO GDE; 1ST LESION", "code_information": [{"code": "10007", "type": "CPT"}, {"code": "200005", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1284.0, "discounted_cash": 256.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10008 FINE NDL ASP BX W/ FLUORO GDE; EA ADD'L LESION", "code_information": [{"code": "10008", "type": "CPT"}, {"code": "200007", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1192.0, "discounted_cash": 238.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10009 FINE NDL ASP BX W/ CT GDE; 1ST LESION", "code_information": [{"code": "10009", "type": "CPT"}, {"code": "200009", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1937.0, "discounted_cash": 387.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10010 FINE NDL ASP BX W/ CT GDE; EA ADD'L LESION", "code_information": [{"code": "10010", "type": "CPT"}, {"code": "200011", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1799.0, "discounted_cash": 359.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10021 FINE NDL ASP BX W/O IMG GDE; 1ST LESION", "code_information": [{"code": "10021", "type": "CPT"}, {"code": "100768", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10030 PRQ CATH DRAIN,SFT TIS(EXT,ABD WALL,NCK)", "code_information": [{"code": "10030", "type": "CPT"}, {"code": "175911", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 186.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10035 PERQ SFT TIS LOC DEV PLMT 1ST LES W/IMGDE", "code_information": [{"code": "10035", "type": "CPT"}, {"code": "187422", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2347.0, "discounted_cash": 469.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10040 ACNE SURGERY", "code_information": [{"code": "10040", "type": "CPT"}, {"code": "100772", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 257.0, "discounted_cash": 51.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10060 I&D ABSCESS,SIMPLE/SINGLE", "code_information": [{"code": "10060", "type": "CPT"}, {"code": "100774", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 47.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10061 I&D OF ABSCESS, COMP/MULT", "code_information": [{"code": "10061", "type": "CPT"}, {"code": "100776", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10080 I&D PILONIDAL CYST; SIMPLE", "code_information": [{"code": "10080", "type": "CPT"}, {"code": "100778", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 162.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10081 I&D PILONIDAL CYST,COMPLICATED", "code_information": [{"code": "10081", "type": "CPT"}, {"code": "100780", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1013.0, "discounted_cash": 202.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10120 INCN & REMVL FB SUBQ TIS;SMPL", "code_information": [{"code": "10120", "type": "CPT"}, {"code": "100782", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10121 INCN & REMVL FB SUBQ TIS;COMPLICATED", "code_information": [{"code": "10121", "type": "CPT"}, {"code": "100784", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2557.0, "discounted_cash": 511.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10140 I&D HEMATOMA/SEROMA OR FLUID COLLECT", "code_information": [{"code": "10140", "type": "CPT"}, {"code": "100786", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1842.0, "discounted_cash": 368.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10160 PUNCT/ASP ABSCESS, HEMAT, BULLA, OR CYST", "code_information": [{"code": "10160", "type": "CPT"}, {"code": "100788", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 10180 I&D, COMPLEX, POSTOP WOUND INFECT", "code_information": [{"code": "10180", "type": "CPT"}, {"code": "100790", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4030.0, "discounted_cash": 806.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11010 DEBRIDE SKIN, FX", "code_information": [{"code": "11010", "type": "CPT"}, {"code": "100794", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2309.0, "discounted_cash": 461.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11012 DEBRIDE SKIN/MUSCLE/BONE, FX", "code_information": [{"code": "11012", "type": "CPT"}, {"code": "100796", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8698.0, "discounted_cash": 1739.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11042 DEBRIDE SQ TIS 1ST <= 20 SQ CM", "code_information": [{"code": "11042", "type": "CPT"}, {"code": "100798", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11043 DEBRIDE MUSL/FAS 1ST <= 20 SQ CM", "code_information": [{"code": "11043", "type": "CPT"}, {"code": "100800", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 145.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11044 DEBRIDE BONE 1ST <= 20 SQ CM", "code_information": [{"code": "11044", "type": "CPT"}, {"code": "100802", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1993.0, "discounted_cash": 398.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11045 DEBRIDE SQ TIS EA ADD'L <=20 SQ", "code_information": [{"code": "11045", "type": "CPT"}, {"code": "100804", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 417.0, "discounted_cash": 83.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11046 DEBRIDE MUSL/FAS EA ADD'L <=20 S", "code_information": [{"code": "11046", "type": "CPT"}, {"code": "100806", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 105.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11047 DEBRIDE BONE EA ADD'L <=20 SQ CM", "code_information": [{"code": "11047", "type": "CPT"}, {"code": "100808", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1446.0, "discounted_cash": 289.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11055 PARING BENIGN SKIN LESION,SGL", "code_information": [{"code": "11055", "type": "CPT"}, {"code": "100810", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11056 PARING BENIGN SKIN LES,2-4", "code_information": [{"code": "11056", "type": "CPT"}, {"code": "100814", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11057 PARING BENIGN SKIN LES,>4", "code_information": [{"code": "11057", "type": "CPT"}, {"code": "100816", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 274.0, "discounted_cash": 54.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11102 TANGNTL BX SKIN; SNGL LESION", "code_information": [{"code": "11102", "type": "CPT"}, {"code": "200017", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 377.0, "discounted_cash": 75.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11103 TANGNTL BX SKIN; EA SEP/ADD'L LESION", "code_information": [{"code": "11103", "type": "CPT"}, {"code": "200023", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 21.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11104 PUNCH BX SKIN; SNGL LESION", "code_information": [{"code": "11104", "type": "CPT"}, {"code": "200019", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11105 PUNCH BX SKIN; EA SEP/ADD'L LESION", "code_information": [{"code": "11105", "type": "CPT"}, {"code": "200025", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 21.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11106 INCISNL BX SKIN; SNGL LESION", "code_information": [{"code": "11106", "type": "CPT"}, {"code": "200021", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 771.0, "discounted_cash": 154.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11107 INCISNL BX SKIN; EA SEP/ADD'L LESION", "code_information": [{"code": "11107", "type": "CPT"}, {"code": "200027", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 25.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11200 REMOVAL SKIN TAGS, <=15 LES", "code_information": [{"code": "11200", "type": "CPT"}, {"code": "100820", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11201 REMOVAL SKIN TAGS, ADD-ON, EA ADD'L 10<", "code_information": [{"code": "11201", "type": "CPT"}, {"code": "100822", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 40.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11300 SHAV SKIN LES SNGL T/A/L; 0.5CM/<", "code_information": [{"code": "11300", "type": "CPT"}, {"code": "100824", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11301 SHAV SKIN LES SNGL T/A/L; 0.6-1.0 CM", "code_information": [{"code": "11301", "type": "CPT"}, {"code": "100826", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11302 SHAV SKIN LES SNGL T/A/L; 1.1-2.0 CM", "code_information": [{"code": "11302", "type": "CPT"}, {"code": "100828", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11303 SHAV SKIN LES SNGL T/A/L; >2.0 CM", "code_information": [{"code": "11303", "type": "CPT"}, {"code": "100830", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11305 SHAV SKIN LES SNGL S/N/H/F/G; 0.5 CM/<", "code_information": [{"code": "11305", "type": "CPT"}, {"code": "100832", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11306 SHAV SKIN LES SNGL S/N/H/F/G; 0.6-1.0 CM", "code_information": [{"code": "11306", "type": "CPT"}, {"code": "100834", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11307 SHAV SKIN LES SNGL S/N/H/F/G; 1.1-2.0 CM", "code_information": [{"code": "11307", "type": "CPT"}, {"code": "100836", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11308 SHAV SKIN LES SNGL S/N/H/F/G; >2.0 CM", "code_information": [{"code": "11308", "type": "CPT"}, {"code": "100838", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 441.0, "discounted_cash": 88.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11310 SHAV SKIN LES SNGL F/E/E/N/L/M; 0.5 CM/<", "code_information": [{"code": "11310", "type": "CPT"}, {"code": "100840", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 363.0, "discounted_cash": 72.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11311 SHAV SKIN LES SNGL F/E/E/N/L/M; 0.6-1.0 CM", "code_information": [{"code": "11311", "type": "CPT"}, {"code": "100842", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 347.0, "discounted_cash": 69.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11312 SHAV SKIN LES SNGL F/E/E/N/L/M; 1.1-2.0 CM", "code_information": [{"code": "11312", "type": "CPT"}, {"code": "100844", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 85.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11400 EXC LES B9MARG T/A/L; 0.5 < CM", "code_information": [{"code": "11400", "type": "CPT"}, {"code": "100848", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 776.0, "discounted_cash": 155.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11401 EXC LES B9MARG T/A/L; 0.6-1 CM", "code_information": [{"code": "11401", "type": "CPT"}, {"code": "100850", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 144.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11402 EXC LES B9MARG T/A/L; 1.1-2 CM", "code_information": [{"code": "11402", "type": "CPT"}, {"code": "100852", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 776.0, "discounted_cash": 155.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11403 EXC LES B9MARG T/A/L; 2.1-3.0 CM", "code_information": [{"code": "11403", "type": "CPT"}, {"code": "100854", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1205.0, "discounted_cash": 241.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11404 EXC LES B9MARG T/A/L; 3.1-4.0 CM", "code_information": [{"code": "11404", "type": "CPT"}, {"code": "100856", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2557.0, "discounted_cash": 511.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11406 EXC LES B9MARG T/A/L; > 4.0 CM", "code_information": [{"code": "11406", "type": "CPT"}, {"code": "100858", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2557.0, "discounted_cash": 511.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11420 EXC LES B9MARG S/N/H/F/G; 0.5 CM/<", "code_information": [{"code": "11420", "type": "CPT"}, {"code": "100860", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2067.0, "discounted_cash": 413.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11421 EXC LES B9MARG S/N/H/F/G; 0.6-1.0CM", "code_information": [{"code": "11421", "type": "CPT"}, {"code": "100862", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1205.0, "discounted_cash": 241.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11422 EXC LES B9MARG S/N/H/F/G; 1.1-2.0CM", "code_information": [{"code": "11422", "type": "CPT"}, {"code": "100864", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2067.0, "discounted_cash": 413.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11423 EXC LES B9MARG S/N/H/F/G; 2.1-3.0CM", "code_information": [{"code": "11423", "type": "CPT"}, {"code": "100866", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2557.0, "discounted_cash": 511.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11424 EXC LES B9MARG S/N/H/F/G; 3.1-4.0CM", "code_information": [{"code": "11424", "type": "CPT"}, {"code": "100868", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1993.0, "discounted_cash": 398.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11426 EXC LES B9MARG S/N/H/F/G; > 4.0CM", "code_information": [{"code": "11426", "type": "CPT"}, {"code": "100870", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3284.0, "discounted_cash": 656.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11440 EXC LES B9MARG F/E/E/N/L/M; 0.5CM/<", "code_information": [{"code": "11440", "type": "CPT"}, {"code": "100872", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 914.0, "discounted_cash": 182.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11441 EXC LES B9MARG F/E/E/N/L/M; 0.6-1.0CM", "code_information": [{"code": "11441", "type": "CPT"}, {"code": "100874", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 776.0, "discounted_cash": 155.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11442 EXC LES B9MARG F/E/E/N/L/M; 1.1-2.0CM", "code_information": [{"code": "11442", "type": "CPT"}, {"code": "100876", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1205.0, "discounted_cash": 241.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11443 EXC LES B9MARG F/E/E/N/L/M; 2.1-3.0CM", "code_information": [{"code": "11443", "type": "CPT"}, {"code": "100878", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1905.0, "discounted_cash": 381.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11450 EXC HIDRADENITIS AXILLARY SMPL/INTRM RP", "code_information": [{"code": "11450", "type": "CPT"}, {"code": "185115", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3734.0, "discounted_cash": 746.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11600 EXC MAL LES T/A/L; 0.5CM/<", "code_information": [{"code": "11600", "type": "CPT"}, {"code": "100882", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1205.0, "discounted_cash": 241.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11601 EXC MAL LES T/A/L; 0.6-1 CM", "code_information": [{"code": "11601", "type": "CPT"}, {"code": "100884", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 776.0, "discounted_cash": 155.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11602 EXC MAL LES T/A/L; 1.1 TO 2.0CM", "code_information": [{"code": "11602", "type": "CPT"}, {"code": "100886", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 144.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11603 EXC MAL LES T/A/L; 2.1 TO 3.0CM", "code_information": [{"code": "11603", "type": "CPT"}, {"code": "100888", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1205.0, "discounted_cash": 241.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11604 EXC MAL LES T/A/L; 3.1 TO 4.0CM", "code_information": [{"code": "11604", "type": "CPT"}, {"code": "100890", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 162.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11606 EXC MAL LES T/A/L; > 4.0CM", "code_information": [{"code": "11606", "type": "CPT"}, {"code": "186000", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1905.0, "discounted_cash": 381.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11620 EXC MAL LES S/N/H/F/G; 0.5 CM/<", "code_information": [{"code": "11620", "type": "CPT"}, {"code": "100892", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2243.0, "discounted_cash": 448.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11621 EXC MAL LES S/N/H/F/G; 0.6-1.0 CM", "code_information": [{"code": "11621", "type": "CPT"}, {"code": "100894", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1364.0, "discounted_cash": 272.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11622 EXC MAL LES S/N/H/F/G; 1.1-2.0 CM", "code_information": [{"code": "11622", "type": "CPT"}, {"code": "100896", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1205.0, "discounted_cash": 241.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11623 EXC MAL LES S/N/H/F/G; 2.1-3.0 CM", "code_information": [{"code": "11623", "type": "CPT"}, {"code": "100898", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1793.0, "discounted_cash": 358.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11640 EXC MAL LES F/E/E/N/L/M; 0.5 CM/<", "code_information": [{"code": "11640", "type": "CPT"}, {"code": "100902", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1446.0, "discounted_cash": 289.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11641 EXC MAL LES F/E/E/N/L/M; 0.6-1.0 CM", "code_information": [{"code": "11641", "type": "CPT"}, {"code": "100904", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 952.0, "discounted_cash": 190.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11642 EXC MAL LES F/E/E/N/L/M 1.1-2.0 CM", "code_information": [{"code": "11642", "type": "CPT"}, {"code": "100906", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 162.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11646 EXC SKIN MALIG >4 CM FACE,FACIAL", "code_information": [{"code": "11646", "type": "CPT"}, {"code": "193422", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2843.0, "discounted_cash": 568.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11719 TRIM NONDYSTROPHIC NAIL(S), ANY NUMBER", "code_information": [{"code": "11719", "type": "CPT"}, {"code": "100908", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 16.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11720 DEBRIDEMENT NAIL(S); 1-5", "code_information": [{"code": "11720", "type": "CPT"}, {"code": "100910", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 27.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11721 DEBRIDEMENT NAIL(S); >= 6", "code_information": [{"code": "11721", "type": "CPT"}, {"code": "100912", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 27.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11730 AVULSION NAIL PLATE,PART/COMPL,SMPL; SNGL", "code_information": [{"code": "11730", "type": "CPT"}, {"code": "100914", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 44.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11732 AVULSION NAIL PLATE,PART/COMPL,SMPL; EA ADD'L", "code_information": [{"code": "11732", "type": "CPT"}, {"code": "100916", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 25.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11740 EVAC SUBUNGUAL HEMATOMA", "code_information": [{"code": "11740", "type": "CPT"}, {"code": "100918", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 31.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11750 EXC. NAIL/MATRIX FOR PERM REM.", "code_information": [{"code": "11750", "type": "CPT"}, {"code": "100920", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 144.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11760 REPAIR OF NAIL BED", "code_information": [{"code": "11760", "type": "CPT"}, {"code": "100924", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 690.0, "discounted_cash": 138.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11765 WEDGE EXC OF NAIL FOLD, TOE", "code_information": [{"code": "11765", "type": "CPT"}, {"code": "100926", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11900 INJ INTO SKIN LESION UP TO 7", "code_information": [{"code": "11900", "type": "CPT"}, {"code": "100932", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 72.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11976 REMOVE CONTRACEPTIVE CAPSULE", "code_information": [{"code": "11976", "type": "CPT"}, {"code": "299246", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 841.0, "discounted_cash": 168.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 11982 REMOVE DRUG IMPLANT DEVICE", "code_information": [{"code": "11982", "type": "CPT"}, {"code": "100936", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 590.0, "discounted_cash": 118.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12001 SMPL REP S/N/AX/G/TR; 2.5CM/<", "code_information": [{"code": "12001", "type": "CPT"}, {"code": "100940", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12002 SMPL REP S/N/AX/G/TR; 2.6-7.5CM", "code_information": [{"code": "12002", "type": "CPT"}, {"code": "100942", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12004 SMPL REP S/N/AX/G/TR; 7.6-12.5CM", "code_information": [{"code": "12004", "type": "CPT"}, {"code": "100944", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12005 SMPL REP S/N/A/G/T/H/F; 12.6-20.0 CM", "code_information": [{"code": "12005", "type": "CPT"}, {"code": "100946", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1453.0, "discounted_cash": 290.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12006 SMPL REP S/N/A/G/T/H/F; 20.1-30.0 CM", "code_information": [{"code": "12006", "type": "CPT"}, {"code": "100948", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1530.0, "discounted_cash": 306.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12007 SMPL REP S/N/A/G/T/H/F; >30.0CM", "code_information": [{"code": "12007", "type": "CPT"}, {"code": "100950", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1554.0, "discounted_cash": 310.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12011 SMPL REP F/E/E/N/L/MM; <=2.5CM", "code_information": [{"code": "12011", "type": "CPT"}, {"code": "100952", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12013 SMPL REP F/E/E/N/L/M; 2.6-5.0 CM", "code_information": [{"code": "12013", "type": "CPT"}, {"code": "100954", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 292.0, "discounted_cash": 58.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12014 SMPL REP F/E/E/N/L/MM; 5.1-7.5 CM", "code_information": [{"code": "12014", "type": "CPT"}, {"code": "100956", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1391.0, "discounted_cash": 278.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12015 SMPL REP F/E/E/N/L/MM; 7.6-12.5 CM", "code_information": [{"code": "12015", "type": "CPT"}, {"code": "100958", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1418.0, "discounted_cash": 283.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12016 SMPL REP F/E/E/N/L/MM; 12.6-20.0 CM", "code_information": [{"code": "12016", "type": "CPT"}, {"code": "100960", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1418.0, "discounted_cash": 283.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12018 SMPL REP F/E/E/N/L/MM; >30.0 CM", "code_information": [{"code": "12018", "type": "CPT"}, {"code": "100964", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5600.0, "discounted_cash": 1120.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12020 TX SUPERFICIAL WND DEHISCENCE SMPL CLOSURE", "code_information": [{"code": "12020", "type": "CPT"}, {"code": "100966", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 907.0, "discounted_cash": 181.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12021 TX SUPERFICIAL WOUND DEHISCENCE W/PACKING", "code_information": [{"code": "12021", "type": "CPT"}, {"code": "100968", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1310.0, "discounted_cash": 262.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12031 LAC. REP. INTERMED S/A/T/EXT </=2.5 CM", "code_information": [{"code": "12031", "type": "CPT"}, {"code": "100970", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 447.0, "discounted_cash": 89.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12032 LAC. RPR, INTERMED 2.6-7.5 CM", "code_information": [{"code": "12032", "type": "CPT"}, {"code": "100972", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 90.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12034 LAC. RPR, INTERMED 7.6-12.5 CM", "code_information": [{"code": "12034", "type": "CPT"}, {"code": "100974", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 85.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12035 LAC. RPR, INTERMED 12.6-20.0 CM", "code_information": [{"code": "12035", "type": "CPT"}, {"code": "100976", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1504.0, "discounted_cash": 300.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12036 LAC. RPR, INTERMED 20.1-30.0 CM", "code_information": [{"code": "12036", "type": "CPT"}, {"code": "100978", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1698.0, "discounted_cash": 339.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12037 LAC. REPAIR INTERMED > 30CM", "code_information": [{"code": "12037", "type": "CPT"}, {"code": "100980", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4915.0, "discounted_cash": 983.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12041 LAC. REP. INTERMED N-T/GENIT </=2.5 CM", "code_information": [{"code": "12041", "type": "CPT"}, {"code": "100982", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12042 LAYER CLOSURE,WOUND 2.6-7.5CM", "code_information": [{"code": "12042", "type": "CPT"}, {"code": "100984", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 592.0, "discounted_cash": 118.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12044 LAC. RPR, INTERMED 7.6-12.5 CM", "code_information": [{"code": "12044", "type": "CPT"}, {"code": "100986", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1534.0, "discounted_cash": 306.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12045 RPR INTMD WND N-HG/GENITALIA", "code_information": [{"code": "12045", "type": "CPT"}, {"code": "100988", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2062.0, "discounted_cash": 412.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12051 LAC. RPR, INTERMED F/E/E/N/L&/MUC </=2.5 CM", "code_information": [{"code": "12051", "type": "CPT"}, {"code": "100994", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 441.0, "discounted_cash": 88.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12052 LAC. RPR, INTERMED 2.6-5.0 CM", "code_information": [{"code": "12052", "type": "CPT"}, {"code": "100996", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 447.0, "discounted_cash": 89.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12053 LAC. RPR, INTERMED 5.1-7.5 CM", "code_information": [{"code": "12053", "type": "CPT"}, {"code": "100998", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 441.0, "discounted_cash": 88.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12054 LAC. RPR, INTERMED F/E/E/N/L&/MUC 7.6-12.5CM", "code_information": [{"code": "12054", "type": "CPT"}, {"code": "101000", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1534.0, "discounted_cash": 306.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 12055 LAC. RPR, INTERMED 12.6-20.0 CM", "code_information": [{"code": "12055", "type": "CPT"}, {"code": "101002", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2062.0, "discounted_cash": 412.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13100 LAC. COMPLEX TRUNK 1.1-2.5CM", "code_information": [{"code": "13100", "type": "CPT"}, {"code": "101008", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 826.0, "discounted_cash": 165.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13101 LAC. COMPLEX TRUNK 2.6-7.5CM", "code_information": [{"code": "13101", "type": "CPT"}, {"code": "101010", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2994.0, "discounted_cash": 598.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13102 LAC. CMPLX TRUNK;EA ADDL 5CM/<", "code_information": [{"code": "13102", "type": "CPT"}, {"code": "101012", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2016.0, "discounted_cash": 403.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13120 LAC. SCALP, ARMS, LEGS 1.1-2.5", "code_information": [{"code": "13120", "type": "CPT"}, {"code": "101014", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1359.0, "discounted_cash": 271.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13121 LAC. SCALP, ARMS. LEGS 2.6-7.5", "code_information": [{"code": "13121", "type": "CPT"}, {"code": "101016", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1461.0, "discounted_cash": 292.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13122 REPAIR,COMPLX EA ADD 5CM OR LE", "code_information": [{"code": "13122", "type": "CPT"}, {"code": "101018", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1095.0, "discounted_cash": 219.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13131 LAC. CHEEKS,CHIN,MOUTH 1.1-2.5", "code_information": [{"code": "13131", "type": "CPT"}, {"code": "101020", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1349.0, "discounted_cash": 269.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13132 LAC. CHEEKS,CHIN,MOUTH 2.6-7.5", "code_information": [{"code": "13132", "type": "CPT"}, {"code": "101022", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1489.0, "discounted_cash": 297.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13133 CREP H/A/G/EXTR; EA ADD 5 CM/<", "code_information": [{"code": "13133", "type": "CPT"}, {"code": "101024", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2661.0, "discounted_cash": 532.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13151 LAC. EYE,NOSE,EARS 1.1-2.5CM", "code_information": [{"code": "13151", "type": "CPT"}, {"code": "101028", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1489.0, "discounted_cash": 297.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13152 LAC. EYE, NOSE, EARS 2.6-7.5CM", "code_information": [{"code": "13152", "type": "CPT"}, {"code": "101030", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3831.0, "discounted_cash": 766.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13153 LAC EYE,NOSE,EARS, EA ADD 5CM<", "code_information": [{"code": "13153", "type": "CPT"}, {"code": "101032", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1242.0, "discounted_cash": 248.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 13160 SECONDARY CLOSURE OF WOUND", "code_information": [{"code": "13160", "type": "CPT"}, {"code": "299548", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9051.0, "discounted_cash": 1810.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 14020 TISSUE XFER-TRUNK <=10 SQ CM", "code_information": [{"code": "14020", "type": "CPT"}, {"code": "101036", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8795.0, "discounted_cash": 1759.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15002 SURG PREP,TRUNK/ARM/LEG,CHILD", "code_information": [{"code": "15002", "type": "CPT"}, {"code": "101042", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2408.0, "discounted_cash": 481.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15003 SURG PREP,TRUNK/ARM/LEG,CHILD", "code_information": [{"code": "15003", "type": "CPT"}, {"code": "101044", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 940.0, "discounted_cash": 188.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15004 SURG PREP,FACE/SCALP/EYE,CHILD", "code_information": [{"code": "15004", "type": "CPT"}, {"code": "101046", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 811.0, "discounted_cash": 162.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15005 PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT", "code_information": [{"code": "15005", "type": "CPT"}, {"code": "101048", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 354.0, "discounted_cash": 70.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15271 SKIN GRFT T/A/L <=100 SQ CM; 1ST 25 SQ CM", "code_information": [{"code": "15271", "type": "CPT"}, {"code": "152877", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2042.0, "discounted_cash": 408.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15272 SKIN GRFT T/A/L <=100 SQ CM; ADDL 25 SQ CM", "code_information": [{"code": "15272", "type": "CPT"}, {"code": "152879", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1324.0, "discounted_cash": 264.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15273 SKIN GRFT T/A/L CH >= 100 SQ CM; 1ST 100 SQ CM", "code_information": [{"code": "15273", "type": "CPT"}, {"code": "152881", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4536.0, "discounted_cash": 907.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15274 SKIN GRFT T/A/L CH >= 100 SQ CM; ADDL 100 SQ CM", "code_information": [{"code": "15274", "type": "CPT"}, {"code": "152883", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1525.0, "discounted_cash": 305.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15275 SKIN GRFT F/N/HF/G <=100 SQ CM; 1ST 25 SQ CM", "code_information": [{"code": "15275", "type": "CPT"}, {"code": "152885", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2042.0, "discounted_cash": 408.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15276 SKIN GRFT F/N/HF/G <=100 SQ CM; ADDL 25 SQ CM", "code_information": [{"code": "15276", "type": "CPT"}, {"code": "152887", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1021.0, "discounted_cash": 204.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15277 SKN GRFT F/N/HF/G CH >=100 SQ CM; 1ST 100 SQ CM", "code_information": [{"code": "15277", "type": "CPT"}, {"code": "152889", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2411.0, "discounted_cash": 482.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15853 RMVL SUTURES/STAPLES NOT REQUIRING ANES", "code_information": [{"code": "15853", "type": "CPT"}, {"code": "249446", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 594.0, "discounted_cash": 118.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 15854 RMVL SUTURES&STAPLES NOT REQ ANES", "code_information": [{"code": "15854", "type": "CPT"}, {"code": "249807", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 594.0, "discounted_cash": 118.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 16000 BURN 1 DEG/INITIAL TX", "code_information": [{"code": "16000", "type": "CPT"}, {"code": "101070", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1647.0, "discounted_cash": 329.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 16020 DRS&/DBRDMT P-THKNS BURN 1ST/SM", "code_information": [{"code": "16020", "type": "CPT"}, {"code": "101072", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 56.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 16025 DRESS/DEBRID P-THICK BURN, MED", "code_information": [{"code": "16025", "type": "CPT"}, {"code": "101074", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 56.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 16030 DRESS/DEBRID P-THICK BURN, LRG", "code_information": [{"code": "16030", "type": "CPT"}, {"code": "101076", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 116.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 16035 ESCHAROTOMY", "code_information": [{"code": "16035", "type": "CPT"}, {"code": "101078", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 123.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 17000 DEST PREMALIGNANT LESION 1ST", "code_information": [{"code": "17000", "type": "CPT"}, {"code": "101080", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 17003 DEST PREMALIGNANT LESION 2-14", "code_information": [{"code": "17003", "type": "CPT"}, {"code": "101082", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 64.0, "discounted_cash": 12.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 17004 DEST PREMALIGNANT LESION 15/>", "code_information": [{"code": "17004", "type": "CPT"}, {"code": "101084", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 17110 DEST B9 LESIONS UP TO 14", "code_information": [{"code": "17110", "type": "CPT"}, {"code": "101088", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 17111 DEST B9 LESIONS 15/>", "code_information": [{"code": "17111", "type": "CPT"}, {"code": "101090", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 17250 CHEMICAL CAUTERY, TISSUE", "code_information": [{"code": "17250", "type": "CPT"}, {"code": "101092", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 44.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 17261 DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM", "code_information": [{"code": "17261", "type": "CPT"}, {"code": "101096", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 44.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 17282 DES MAL LES F/E/E/N/L/MM;1.1 TO 2.0CM", "code_information": [{"code": "17282", "type": "CPT"}, {"code": "177355", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 441.0, "discounted_cash": 88.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 17999 UNLSTD PX SKN MUC MEMB &SUBQ TIS", "code_information": [{"code": "17999", "type": "CPT"}, {"code": "101106", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2600.0, "discounted_cash": 520.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19000 PUNCTURE ASPIRATION CYST BREAST", "code_information": [{"code": "19000", "type": "CPT"}, {"code": "101108", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2288.0, "discounted_cash": 457.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19001 PUNCTURE ASPIRATION BREAST EA ADDL CYST", "code_information": [{"code": "19001", "type": "CPT"}, {"code": "101110", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 861.0, "discounted_cash": 172.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19020 MASTOTOMY W/EXPL/DRAINAGE ABSCESS DEEP", "code_information": [{"code": "19020", "type": "CPT"}, {"code": "101112", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1905.0, "discounted_cash": 381.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19030 INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM", "code_information": [{"code": "19030", "type": "CPT"}, {"code": "101114", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 650.0, "discounted_cash": 130.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19081 STEREOTAC BX BRST 1ST LES", "code_information": [{"code": "19081", "type": "CPT"}, {"code": "304662", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5750.0, "discounted_cash": 1150.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19082 STEREOTAC BX BRST EA ADDL LES", "code_information": [{"code": "19082", "type": "CPT"}, {"code": "304664", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2877.0, "discounted_cash": 575.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19083 US BX BRST 1ST LES", "code_information": [{"code": "19083", "type": "CPT"}, {"code": "304666", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5447.0, "discounted_cash": 1089.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19084 US BX BRST EA ADDL LES", "code_information": [{"code": "19084", "type": "CPT"}, {"code": "304668", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2726.0, "discounted_cash": 545.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19085 MRI BX BRST 1ST LES", "code_information": [{"code": "19085", "type": "CPT"}, {"code": "304670", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 7558.0, "discounted_cash": 1511.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19086 MRI BX BRST EA ADDL LES", "code_information": [{"code": "19086", "type": "CPT"}, {"code": "304672", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2519.0, "discounted_cash": 503.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19100 BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX", "code_information": [{"code": "19100", "type": "CPT"}, {"code": "101116", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 5065.0, "discounted_cash": 1013.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19101 BIOPSY BREAST OPEN INCISIONAL", "code_information": [{"code": "19101", "type": "CPT"}, {"code": "295438", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 4636.0, "discounted_cash": 927.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19120 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LES", "code_information": [{"code": "19120", "type": "CPT"}, {"code": "101122", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 4636.0, "discounted_cash": 927.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19281 MG PLCMT PERQ DEV BRST 1ST LES", "code_information": [{"code": "19281", "type": "CPT"}, {"code": "304674", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3290.0, "discounted_cash": 658.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19282 MG PLCMT PERQ DEV BRST EA ADDL LES", "code_information": [{"code": "19282", "type": "CPT"}, {"code": "304676", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1645.0, "discounted_cash": 329.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19285 US PLCMT PERQ DEV BREAST 1ST LES", "code_information": [{"code": "19285", "type": "CPT"}, {"code": "304682", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3290.0, "discounted_cash": 658.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19286 US PLCMT PERQ DEV BREAST EA ADDL", "code_information": [{"code": "19286", "type": "CPT"}, {"code": "304684", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1645.0, "discounted_cash": 329.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19287 MRI PLCMT PERQ DEV BREAST 1ST LES", "code_information": [{"code": "19287", "type": "CPT"}, {"code": "304686", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4646.0, "discounted_cash": 929.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 19288 MRI PLCMT PERQ DEV BREAST EA ADDL", "code_information": [{"code": "19288", "type": "CPT"}, {"code": "304688", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2324.0, "discounted_cash": 464.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20100 EXPLORATION PENETRATING WOUND SPX NECK", "code_information": [{"code": "20100", "type": "CPT"}, {"code": "101136", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4645.0, "discounted_cash": 929.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20101 EXPLORATION PENETRATING WOUND SPX CHEST", "code_information": [{"code": "20101", "type": "CPT"}, {"code": "101138", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7786.0, "discounted_cash": 1557.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20103 EXPLORATION PENETRATING WOUND SPX EXTREMITY", "code_information": [{"code": "20103", "type": "CPT"}, {"code": "101140", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9528.0, "discounted_cash": 1905.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20206 BIOPSY MUSCLE PERCUTANEOUS NEEDLE", "code_information": [{"code": "20206", "type": "CPT"}, {"code": "101142", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2340.0, "discounted_cash": 468.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20220 BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL", "code_information": [{"code": "20220", "type": "CPT"}, {"code": "101144", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2583.0, "discounted_cash": 516.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20225 BIOPSY BONE TROCAR/NEEDLE DEEP", "code_information": [{"code": "20225", "type": "CPT"}, {"code": "101146", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 9480.0, "discounted_cash": 1896.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20520 REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE", "code_information": [{"code": "20520", "type": "CPT"}, {"code": "101150", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5165.0, "discounted_cash": 1033.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20525 REM FB MUSCL/TENDON;DEEP/COMPL", "code_information": [{"code": "20525", "type": "CPT"}, {"code": "101152", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 13020.0, "discounted_cash": 2604.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20526 THERAPEUTIC INJ, CARP TUNNEL", "code_information": [{"code": "20526", "type": "CPT"}, {"code": "101154", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 77.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20527 INJ ENZYME,PALMAR FASCIAL CORD", "code_information": [{"code": "20527", "type": "CPT"}, {"code": "166110", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 72.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20550 INJ(S) SGL TENDON SHTH/LIGMNT", "code_information": [{"code": "20550", "type": "CPT"}, {"code": "101156", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 77.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20551 INJ(S) SGL TENDON ORIGIN/INSERT", "code_information": [{"code": "20551", "type": "CPT"}, {"code": "101158", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 77.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20552 INJ SGL/MUL-TRIGGER PT,1-2 MUSL(S)", "code_information": [{"code": "20552", "type": "CPT"}, {"code": "101160", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 77.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20553 INJ TRIGGER POINT 3/> MUSL(S)", "code_information": [{"code": "20553", "type": "CPT"}, {"code": "101162", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 77.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20560 NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES", "code_information": [{"code": "20560", "type": "CPT"}, {"code": "229816", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 119.0, "discounted_cash": 23.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20561 NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES", "code_information": [{"code": "20561", "type": "CPT"}, {"code": "229818", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 21.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20600 ASP/INJ SM JNT/BURSA W/O US GDE", "code_information": [{"code": "20600", "type": "CPT"}, {"code": "101164", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 77.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20604 ASP/INJ SM JNT/BURSA W/ US GDE", "code_information": [{"code": "20604", "type": "CPT"}, {"code": "179875", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 338.0, "discounted_cash": 67.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20605 ASP/INJ INTMED JNT/BURSA W/O US GDE", "code_information": [{"code": "20605", "type": "CPT"}, {"code": "101166", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 77.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20606 ASP/INJ INTMED JNT/BURSA W/ US GDE", "code_information": [{"code": "20606", "type": "CPT"}, {"code": "179879", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 186.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20610 ASP/INJ MJR JNT/BURSA W/O US GDE", "code_information": [{"code": "20610", "type": "CPT"}, {"code": "101168", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 77.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20611 ASP/INJ MJR JNT/BURSA W/ US GDE", "code_information": [{"code": "20611", "type": "CPT"}, {"code": "179901", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 338.0, "discounted_cash": 67.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20612 ASP/INJ GANGLION CYST", "code_information": [{"code": "20612", "type": "CPT"}, {"code": "101170", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 385.0, "discounted_cash": 77.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20670 RMVL OF SUPPORT IMPLANT ; SUPERFICIAL", "code_information": [{"code": "20670", "type": "CPT"}, {"code": "101176", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2412.0, "discounted_cash": 482.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20680 RMVL OF SUPPORT IMPLANT ; DEEP", "code_information": [{"code": "20680", "type": "CPT"}, {"code": "101178", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3445.0, "discounted_cash": 689.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20950 MONITOR INTERST FLD PRESSURE", "code_information": [{"code": "20950", "type": "CPT"}, {"code": "101180", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 785.0, "discounted_cash": 157.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20982 ABLATJ BONE TUMOR(S) PERQ; RF", "code_information": [{"code": "20982", "type": "CPT"}, {"code": "180417", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 18337.0, "discounted_cash": 3667.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 20999 UNLSTD PROC,MUSCLOSKLTL SYS,GENRL", "code_information": [{"code": "20999", "type": "CPT"}, {"code": "175945", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3431.0, "discounted_cash": 686.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21110 APPL INTERDENTAL FIXATION DEVICE", "code_information": [{"code": "21110", "type": "CPT"}, {"code": "101192", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4017.0, "discounted_cash": 803.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21315 CLSD TX NASAL FX W/MNPJ W/O STABILIZATION", "code_information": [{"code": "21315", "type": "CPT"}, {"code": "180931", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4924.0, "discounted_cash": 984.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21337 CLSD TX NASAL SEPTAL FX W/WO MANIPULATION", "code_information": [{"code": "21337", "type": "CPT"}, {"code": "199974", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5650.0, "discounted_cash": 1130.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21421 CLSD TX PALATAL/MAXILARRY FX", "code_information": [{"code": "21421", "type": "CPT"}, {"code": "101204", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6505.0, "discounted_cash": 1301.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21440 CLSD TX DENTAL RIDGE FX", "code_information": [{"code": "21440", "type": "CPT"}, {"code": "177397", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5978.0, "discounted_cash": 1195.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21451 CLSD TMT MANDIBULAR FX W/MANIP", "code_information": [{"code": "21451", "type": "CPT"}, {"code": "176296", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9303.0, "discounted_cash": 1860.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21453 CLSD TX MAND-FX W INTERDENTA FIX", "code_information": [{"code": "21453", "type": "CPT"}, {"code": "101206", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 16487.0, "discounted_cash": 3297.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21480 CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ", "code_information": [{"code": "21480", "type": "CPT"}, {"code": "101208", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1201.0, "discounted_cash": 240.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21497 INTERDENTAL WIRING, OTH THN FX", "code_information": [{"code": "21497", "type": "CPT"}, {"code": "180094", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3903.0, "discounted_cash": 780.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21550 BIOPSY SOFT TISSUE NECK/THORAX", "code_information": [{"code": "21550", "type": "CPT"}, {"code": "180153", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3319.0, "discounted_cash": 663.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21931 EXC TUMOR,SFT TIS BK/FLNK;3CM>", "code_information": [{"code": "21931", "type": "CPT"}, {"code": "101218", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1989.0, "discounted_cash": 397.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 21933 EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM", "code_information": [{"code": "21933", "type": "CPT"}, {"code": "193570", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3602.0, "discounted_cash": 720.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 22310 CLTX VRT BDY FX W/O MNPJ REQ&W/CSTING/BRACING", "code_information": [{"code": "22310", "type": "CPT"}, {"code": "101222", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1777.0, "discounted_cash": 355.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 22510 PERQ VERTBPLSTY CERVICOTHOR,UNI/BIL", "code_information": [{"code": "22510", "type": "CPT"}, {"code": "179939", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8388.0, "discounted_cash": 1677.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 22511 PERQ VERTBPLSTY LUMBOSAC,UNI/BIL", "code_information": [{"code": "22511", "type": "CPT"}, {"code": "179941", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8091.0, "discounted_cash": 1618.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 22512 PERQ VERTBPLSTY,EA ADDL CTH,LS,UNI/BIL", "code_information": [{"code": "22512", "type": "CPT"}, {"code": "179943", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4046.0, "discounted_cash": 809.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 22612 ARTHRODESIS POSTERIOR/POSTEROLATERAL LUMBAR", "code_information": [{"code": "22612", "type": "CPT"}, {"code": "178597", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 22548.0, "discounted_cash": 4509.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 22842 POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG", "code_information": [{"code": "22842", "type": "CPT"}, {"code": "178599", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2556.0, "discounted_cash": 511.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 22900 EXC TUM SFT TIS ABDL WALL SUBFASCIAL <5CM", "code_information": [{"code": "22900", "type": "CPT"}, {"code": "219899", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2976.0, "discounted_cash": 595.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23330 REMOVAL FB SHOULDER SUBCUTANEOUS", "code_information": [{"code": "23330", "type": "CPT"}, {"code": "295414", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4529.0, "discounted_cash": 905.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23333 REMOVAL FOREIGN BDY SHLDR DEEP", "code_information": [{"code": "23333", "type": "CPT"}, {"code": "304583", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6978.0, "discounted_cash": 1395.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23350 INJECTION SHOULDER ARTHROGRAPHY", "code_information": [{"code": "23350", "type": "CPT"}, {"code": "101234", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1101.0, "discounted_cash": 220.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23406 INCISE TENDON(S) & MUSCLE(S)", "code_information": [{"code": "23406", "type": "CPT"}, {"code": "383528", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 7091.0, "discounted_cash": 1418.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23500 CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION", "code_information": [{"code": "23500", "type": "CPT"}, {"code": "101236", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 55.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23505 CLSD TX CLAVICULAR FRACTURE W/MANIPULATION", "code_information": [{"code": "23505", "type": "CPT"}, {"code": "101238", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 11847.0, "discounted_cash": 2369.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23540 CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION", "code_information": [{"code": "23540", "type": "CPT"}, {"code": "101240", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1574.0, "discounted_cash": 314.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23545 CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION", "code_information": [{"code": "23545", "type": "CPT"}, {"code": "101242", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1632.0, "discounted_cash": 326.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23570 CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION", "code_information": [{"code": "23570", "type": "CPT"}, {"code": "101244", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 55.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23575 CLSD TX SCAPULAR FX W MANIP", "code_information": [{"code": "23575", "type": "CPT"}, {"code": "101246", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3674.0, "discounted_cash": 734.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23600 CLSD TX HUM NECK FX,W/O MANIP", "code_information": [{"code": "23600", "type": "CPT"}, {"code": "101248", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 278.0, "discounted_cash": 55.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23605 CLSD TX HUM NECK FX,W/MANIP", "code_information": [{"code": "23605", "type": "CPT"}, {"code": "101250", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 11847.0, "discounted_cash": 2369.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23620 CLSD TX GR TUBEROSITY FX; WO MAN", "code_information": [{"code": "23620", "type": "CPT"}, {"code": "101252", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23625 CLSD TX GR TUBEROS FX W/MANIPL", "code_information": [{"code": "23625", "type": "CPT"}, {"code": "101254", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 11847.0, "discounted_cash": 2369.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23650 CLSD TX SHLDR DISLOC W/MANIP", "code_information": [{"code": "23650", "type": "CPT"}, {"code": "101256", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1677.0, "discounted_cash": 335.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23655 CLSD TX SHLDR DISL,W MANIP;W ANE", "code_information": [{"code": "23655", "type": "CPT"}, {"code": "101258", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4070.0, "discounted_cash": 814.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23665 CLSD TX SHLD DISLOC,W/MANIP", "code_information": [{"code": "23665", "type": "CPT"}, {"code": "101260", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1773.0, "discounted_cash": 354.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23675 CLSD TX SHOULDER DISLC W/SURG/ANT", "code_information": [{"code": "23675", "type": "CPT"}, {"code": "101262", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1420.0, "discounted_cash": 284.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23930 I&D UPPER ARM OR ELBOW DEEP AB", "code_information": [{"code": "23930", "type": "CPT"}, {"code": "101264", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7679.0, "discounted_cash": 1535.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 23931 INCISION&DRAINAGE UPPER ARM/ELBOW BURSA", "code_information": [{"code": "23931", "type": "CPT"}, {"code": "101266", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7221.0, "discounted_cash": 1444.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24075 EXC ARM/ELBOW LES SC < 3 CM", "code_information": [{"code": "24075", "type": "CPT"}, {"code": "297349", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2340.0, "discounted_cash": 468.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24200 RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS", "code_information": [{"code": "24200", "type": "CPT"}, {"code": "101270", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2200.0, "discounted_cash": 440.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24201 REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP", "code_information": [{"code": "24201", "type": "CPT"}, {"code": "101272", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6629.0, "discounted_cash": 1325.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24220 INJECTION ELBOW ARTHROGRAPHY", "code_information": [{"code": "24220", "type": "CPT"}, {"code": "101274", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 922.0, "discounted_cash": 184.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24357 PERC TENOTOMY ELBOW LAT/MDAL", "code_information": [{"code": "24357", "type": "CPT"}, {"code": "187194", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3221.0, "discounted_cash": 644.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24500 CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION", "code_information": [{"code": "24500", "type": "CPT"}, {"code": "101276", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 345.0, "discounted_cash": 69.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24505 CLTX HUMERAL SHFT FX W/MANIPULATION -SKEL TRACJ", "code_information": [{"code": "24505", "type": "CPT"}, {"code": "259484", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2040.0, "discounted_cash": 408.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24530 CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX-MNPJ", "code_information": [{"code": "24530", "type": "CPT"}, {"code": "101278", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 62.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24535 CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MNPJ", "code_information": [{"code": "24535", "type": "CPT"}, {"code": "101280", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3674.0, "discounted_cash": 734.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24560 CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MNPJ", "code_information": [{"code": "24560", "type": "CPT"}, {"code": "101282", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1409.0, "discounted_cash": 281.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24565CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MNPJ", "code_information": [{"code": "24565", "type": "CPT"}, {"code": "101284", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3770.0, "discounted_cash": 754.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24576 CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MNPJ", "code_information": [{"code": "24576", "type": "CPT"}, {"code": "101286", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1409.0, "discounted_cash": 281.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24600 TREATMENT CLOSED ELBOW DISLOCATION W/O ANES", "code_information": [{"code": "24600", "type": "CPT"}, {"code": "101288", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1656.0, "discounted_cash": 331.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24605 TX CL ELBOW DISLOC W ANESTH", "code_information": [{"code": "24605", "type": "CPT"}, {"code": "101290", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9396.0, "discounted_cash": 1879.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24620 CLSD TX FX DISLOC AT ELBOW W/MANIP", "code_information": [{"code": "24620", "type": "CPT"}, {"code": "101292", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 11847.0, "discounted_cash": 2369.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24640 CLSD TX RAD HEAD SUBLUX,CHILD W/MANIP", "code_information": [{"code": "24640", "type": "CPT"}, {"code": "101294", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24650 CLSD TX RAD/NECK FX,W/O MANIP", "code_information": [{"code": "24650", "type": "CPT"}, {"code": "101296", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 55.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24655 CLSD TX RADIAL HD/NECK FX; W MAN", "code_information": [{"code": "24655", "type": "CPT"}, {"code": "301537", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2210.0, "discounted_cash": 442.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24670 CLSD TX ULNA FX,W/O MANIPULATION", "code_information": [{"code": "24670", "type": "CPT"}, {"code": "101298", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 55.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24675 CLSD TX ULNAR FX PROX END W MANJ", "code_information": [{"code": "24675", "type": "CPT"}, {"code": "273757", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5418.0, "discounted_cash": 1083.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 24999 UNLSD PROC, HUMERUS/ELBOW", "code_information": [{"code": "24999", "type": "CPT"}, {"code": "186103", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2142.0, "discounted_cash": 428.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25000 INC, EXC TENDON SHEATH, WRIST", "code_information": [{"code": "25000", "type": "CPT"}, {"code": "101300", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7079.0, "discounted_cash": 1415.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25028 I&D FOREARM &/OR WRIST DEEP", "code_information": [{"code": "25028", "type": "CPT"}, {"code": "101302", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8845.0, "discounted_cash": 1769.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25246 INJ FOR WRIST ARTHROGRAPHY", "code_information": [{"code": "25246", "type": "CPT"}, {"code": "101304", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1293.0, "discounted_cash": 258.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25248 EXPL W/REM DEEP FB F/ARM WRIST", "code_information": [{"code": "25248", "type": "CPT"}, {"code": "101306", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8967.0, "discounted_cash": 1793.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25260 RPR FOREARM TENDON/MUSC, EA", "code_information": [{"code": "25260", "type": "CPT"}, {"code": "101308", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9040.0, "discounted_cash": 1808.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25500 CLSD TX RAD SHAFT FX,W/O MANIP", "code_information": [{"code": "25500", "type": "CPT"}, {"code": "101310", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 278.0, "discounted_cash": 55.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25505 CLSD TX RAD SHAFT FX W/MANIP", "code_information": [{"code": "25505", "type": "CPT"}, {"code": "101312", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1672.0, "discounted_cash": 334.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25530 CLSD TX ULNAR SHAFT FX,W/O MANIP", "code_information": [{"code": "25530", "type": "CPT"}, {"code": "101314", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 55.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25535 CLSD TX ULNAR SHFT FX W MANIP", "code_information": [{"code": "25535", "type": "CPT"}, {"code": "101316", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1295.0, "discounted_cash": 259.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25560 CLSD TX RAD-ULNA SHAFT FX,W/O MANIP", "code_information": [{"code": "25560", "type": "CPT"}, {"code": "101318", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 55.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25565 CLSD TX RAD-ULNAR FX,W MANIP", "code_information": [{"code": "25565", "type": "CPT"}, {"code": "101320", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1823.0, "discounted_cash": 364.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25600 CLSD TX DISTAL RAD FX,W/O MANIP", "code_information": [{"code": "25600", "type": "CPT"}, {"code": "101322", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 57.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25605 CLSD TX DISTAL RAD FX,W MANIP", "code_information": [{"code": "25605", "type": "CPT"}, {"code": "101324", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1823.0, "discounted_cash": 364.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25609 OPEN TX DISTAL RADIAL IA FX", "code_information": [{"code": "25609", "type": "CPT"}, {"code": "101326", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 15646.0, "discounted_cash": 3129.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25622 CLSD TX NAVICULAR FX,W/O MANIP", "code_information": [{"code": "25622", "type": "CPT"}, {"code": "101328", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 55.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25624 CLSD TX CARPAL SCAPHOID FX,W MANIP", "code_information": [{"code": "25624", "type": "CPT"}, {"code": "177558", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3660.0, "discounted_cash": 732.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25630 CLSD TX CARPAL FX,W/O MANIP EA BONE", "code_information": [{"code": "25630", "type": "CPT"}, {"code": "101330", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 65.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25635 CLSD TX CARPAL FX W MANIP, EA BONE", "code_information": [{"code": "25635", "type": "CPT"}, {"code": "101332", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3674.0, "discounted_cash": 734.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25650 CLSD TX ULNAR STYLOID FRACTURE", "code_information": [{"code": "25650", "type": "CPT"}, {"code": "101334", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1443.0, "discounted_cash": 288.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25675 CLSD TX DIST RADIOULNAR DISLOC W/MANIP", "code_information": [{"code": "25675", "type": "CPT"}, {"code": "101336", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1632.0, "discounted_cash": 326.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25680 CLSD TX TRANS-TRANS-SCAPHOPERI W/MANIP", "code_information": [{"code": "25680", "type": "CPT"}, {"code": "101338", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1498.0, "discounted_cash": 299.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 25690 CLSD TX LUNATE DISLOCAT W/MANIP", "code_information": [{"code": "25690", "type": "CPT"}, {"code": "101340", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5867.0, "discounted_cash": 1173.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26010 I&D FINGER ABSCESS/SIMPLE", "code_information": [{"code": "26010", "type": "CPT"}, {"code": "101342", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 257.0, "discounted_cash": 51.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26011 I&D FINGER ABSC COMPLICATED", "code_information": [{"code": "26011", "type": "CPT"}, {"code": "101344", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1862.0, "discounted_cash": 372.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26020 DRAIN HAND TENDON SHEATH", "code_information": [{"code": "26020", "type": "CPT"}, {"code": "202743", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7725.0, "discounted_cash": 1545.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26040 RELEASE PALM CONTRACTURE; PERC", "code_information": [{"code": "26040", "type": "CPT"}, {"code": "299373", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1903.0, "discounted_cash": 380.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26115 EXC HAND LES SC < 1.5 CM", "code_information": [{"code": "26115", "type": "CPT"}, {"code": "259968", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2352.0, "discounted_cash": 470.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26160 REMOVE TENDON SHEATH LESION", "code_information": [{"code": "26160", "type": "CPT"}, {"code": "297307", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2045.0, "discounted_cash": 409.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26341 MANIP PALM CORD POST INJ,SNGL", "code_information": [{"code": "26341", "type": "CPT"}, {"code": "210086", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 65.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26350 RPR FINGER/HAND TENDON", "code_information": [{"code": "26350", "type": "CPT"}, {"code": "180739", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 11129.0, "discounted_cash": 2225.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26410 REP TENDON HAND W/O GRAFT EACH", "code_information": [{"code": "26410", "type": "CPT"}, {"code": "101350", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7249.0, "discounted_cash": 1449.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26418 RPR, EXTENSOR TENDON FINGER, W/O GRAFT EA", "code_information": [{"code": "26418", "type": "CPT"}, {"code": "101352", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7116.0, "discounted_cash": 1423.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26432 CLST TMT DIST EXT TENDN W/WO PERQ PIN", "code_information": [{"code": "26432", "type": "CPT"}, {"code": "301393", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1903.0, "discounted_cash": 380.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26587 RECONSTRUCT EXTRA FINGER", "code_information": [{"code": "26587", "type": "CPT"}, {"code": "176037", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 5237.0, "discounted_cash": 1047.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26600 CLSD TX METACARP FX,W/O MANIP", "code_information": [{"code": "26600", "type": "CPT"}, {"code": "101354", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 278.0, "discounted_cash": 55.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26605 CLSD TX METACARPAL FX W/MANIP", "code_information": [{"code": "26605", "type": "CPT"}, {"code": "101356", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26608 PERC SK FIXATION MC FX; EA BONE", "code_information": [{"code": "26608", "type": "CPT"}, {"code": "101358", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6954.0, "discounted_cash": 1390.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26641 CLSD TX CARPOMETACARPAL THUMB", "code_information": [{"code": "26641", "type": "CPT"}, {"code": "101360", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1712.0, "discounted_cash": 342.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26645 TREAT THUMB FX/DISLOC,MANIP", "code_information": [{"code": "26645", "type": "CPT"}, {"code": "202170", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3524.0, "discounted_cash": 704.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26670 CLSD TMT HAND DISLOCATION W/O ANES", "code_information": [{"code": "26670", "type": "CPT"}, {"code": "101362", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26700 CLSD TX MP DISLOC SGL,W MANIP", "code_information": [{"code": "26700", "type": "CPT"}, {"code": "101366", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26720 CLSD TX PHALANGE FX, W/O MANIP", "code_information": [{"code": "26720", "type": "CPT"}, {"code": "101368", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26725 CLSD TX FINGER FX,W MANIP EA", "code_information": [{"code": "26725", "type": "CPT"}, {"code": "101370", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 62.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26740 CLSD TX FINGER FX,W/O MANIP,EA", "code_information": [{"code": "26740", "type": "CPT"}, {"code": "101372", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 61.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26742 CLSD TX ARTIC FX,MP/IP JNT,W MANIP EA", "code_information": [{"code": "26742", "type": "CPT"}, {"code": "101374", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1611.0, "discounted_cash": 322.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26750 CLSD TX DIST PHAL FX,W/O MANIP", "code_information": [{"code": "26750", "type": "CPT"}, {"code": "101376", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26755 CLSD TX D PHAL FX, FGRR/THMB;W MANIP EA", "code_information": [{"code": "26755", "type": "CPT"}, {"code": "101378", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 65.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26756 PERC SKTL FIX D PHAL FX, FING/THMB EA", "code_information": [{"code": "26756", "type": "CPT"}, {"code": "101380", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9437.0, "discounted_cash": 1887.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26765 OPEN TX DISTAL PHALANGEAL FX", "code_information": [{"code": "26765", "type": "CPT"}, {"code": "101382", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 16553.0, "discounted_cash": 3310.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26770 CLSD TX IP DSLO-MAN & W/O ANES", "code_information": [{"code": "26770", "type": "CPT"}, {"code": "101384", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 276.0, "discounted_cash": 55.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26775 CLSD TX IP DSLO-MAN & ANES", "code_information": [{"code": "26775", "type": "CPT"}, {"code": "101386", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2600.0, "discounted_cash": 520.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26910 AMPUTATE METACARPAL, W FNGR/THMB, SNGL", "code_information": [{"code": "26910", "type": "CPT"}, {"code": "184682", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 12523.0, "discounted_cash": 2504.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26951 AMP FINGER W/DIRECT CLOSURE", "code_information": [{"code": "26951", "type": "CPT"}, {"code": "101388", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7622.0, "discounted_cash": 1524.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26952 AMP FING/TH, SGL; W LOC ADV FL", "code_information": [{"code": "26952", "type": "CPT"}, {"code": "101390", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 10105.0, "discounted_cash": 2021.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 26989 UNL PROCEDURE, HANDS OR FINGER", "code_information": [{"code": "26989", "type": "CPT"}, {"code": "101392", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3380.0, "discounted_cash": 676.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27000 INCISION OF HIP TENDON", "code_information": [{"code": "27000", "type": "CPT"}, {"code": "383530", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1589.0, "discounted_cash": 317.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27086 REM FB, PELVIS/HIP SUBQ TISSUE", "code_information": [{"code": "27086", "type": "CPT"}, {"code": "101398", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3734.0, "discounted_cash": 746.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27093 INJEC HIP ARTHROGRAPHY WO/ANES", "code_information": [{"code": "27093", "type": "CPT"}, {"code": "101400", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1322.0, "discounted_cash": 264.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27095 INJEC FOR HIP ARTHROGRAM", "code_information": [{"code": "27095", "type": "CPT"}, {"code": "101402", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 3343.0, "discounted_cash": 668.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27096 INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA", "code_information": [{"code": "27096", "type": "CPT"}, {"code": "178601", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 324.0, "discounted_cash": 64.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27197 CLSD TX PELVIC RING FX W/O MANPJN", "code_information": [{"code": "27197", "type": "CPT"}, {"code": "176285", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 61.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27200 CLSD TX COCCYGEAL FRACTURE", "code_information": [{"code": "27200", "type": "CPT"}, {"code": "101408", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 556.0, "discounted_cash": 111.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27220 CLSD TX OF ACETABULUM X(S);WO MANIP", "code_information": [{"code": "27220", "type": "CPT"}, {"code": "101410", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 288.0, "discounted_cash": 57.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27222 CLSD TX HIP/SOCKT FX MNPJ -SKEL TRAC", "code_information": [{"code": "27222", "type": "CPT"}, {"code": "101412", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8646.0, "discounted_cash": 1729.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27230 CLSD TX FEMUR FX,PROX END,W/O MANIP", "code_information": [{"code": "27230", "type": "CPT"}, {"code": "101414", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1409.0, "discounted_cash": 281.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27232 CLTX FEM FX PROX END NCK W/MNPJ -SKEL TRACJ", "code_information": [{"code": "27232", "type": "CPT"}, {"code": "226458", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5104.0, "discounted_cash": 1020.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27240 CLSD RX INTER/SUBTROCH FX,MANIP", "code_information": [{"code": "27240", "type": "CPT"}, {"code": "211241", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3398.0, "discounted_cash": 679.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27246 CLSD TX GRTR TROCHANTERIC FX", "code_information": [{"code": "27246", "type": "CPT"}, {"code": "301897", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 750.0, "discounted_cash": 150.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27250 CLSD TX HIP DISLOC,TRAUMA,W/O ANES", "code_information": [{"code": "27250", "type": "CPT"}, {"code": "101418", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1530.0, "discounted_cash": 306.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27252 CLTX HIP DISLC TRAUMTC REQ ANES", "code_information": [{"code": "27252", "type": "CPT"}, {"code": "101420", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3824.0, "discounted_cash": 764.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27265 CLTX POST HIP ARTHRP DISLC W/O ANES", "code_information": [{"code": "27265", "type": "CPT"}, {"code": "101424", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 94.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27266 CLTX POST HIP ARTHRP DISLC REQ ANES", "code_information": [{"code": "27266", "type": "CPT"}, {"code": "101426", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6555.0, "discounted_cash": 1311.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27267 CLSD TMT THIGH FX; W/O MANIP", "code_information": [{"code": "27267", "type": "CPT"}, {"code": "252831", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 10372.0, "discounted_cash": 2074.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27268 CLTX THIGH FX W/MNPJ", "code_information": [{"code": "27268", "type": "CPT"}, {"code": "185892", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5799.0, "discounted_cash": 1159.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27279 ARTHRODESIS SACROILIAC JOINT PERCUTANEOUS", "code_information": [{"code": "27279", "type": "CPT"}, {"code": "178593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4646.0, "discounted_cash": 929.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27299 UNLSTD PROC PELVIS/HIP JOINT", "code_information": [{"code": "27299", "type": "CPT"}, {"code": "181948", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 8315.0, "discounted_cash": 1663.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27301 I&D DP ABSC BURSA/HMTMA THI/KNE REGION", "code_information": [{"code": "27301", "type": "CPT"}, {"code": "101428", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 11558.0, "discounted_cash": 2311.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27306 INCISION OF THIGH TENDON", "code_information": [{"code": "27306", "type": "CPT"}, {"code": "383532", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3221.0, "discounted_cash": 644.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27307 INCISION OF THIGH TENDONS", "code_information": [{"code": "27307", "type": "CPT"}, {"code": "180038", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3221.0, "discounted_cash": 644.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27369 INJ CONTRAST KNEE ARTHOGRAPHY", "code_information": [{"code": "27369", "type": "CPT"}, {"code": "200052", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1548.0, "discounted_cash": 309.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27500 CLTX FEMORAL SHAFT FX W/O MANIPULATION", "code_information": [{"code": "27500", "type": "CPT"}, {"code": "101658", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 61.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27501 CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MNPJ", "code_information": [{"code": "27501", "type": "CPT"}, {"code": "101442", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 268.0, "discounted_cash": 53.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27502 CLTX FEM SHFT FX W/MNPJ -SKN/SKEL TRACJ", "code_information": [{"code": "27502", "type": "CPT"}, {"code": "101444", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4936.0, "discounted_cash": 987.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27503 CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MNPJ", "code_information": [{"code": "27503", "type": "CPT"}, {"code": "101446", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2215.0, "discounted_cash": 443.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27508 CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MNPJ", "code_information": [{"code": "27508", "type": "CPT"}, {"code": "101448", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27510 CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MNPJ", "code_information": [{"code": "27510", "type": "CPT"}, {"code": "101450", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2293.0, "discounted_cash": 458.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27517 CLTX DSTL FEM EPIPHYSL SEP W/MNPJ -SKN/SKEL", "code_information": [{"code": "27517", "type": "CPT"}, {"code": "226436", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5104.0, "discounted_cash": 1020.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27520 CLOSED TX PATELLAR FRACTURE W/O MANIPULATION", "code_information": [{"code": "27520", "type": "CPT"}, {"code": "101452", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 55.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27530 CLTX TIBL FX PROX W/O MNPJ", "code_information": [{"code": "27530", "type": "CPT"}, {"code": "101454", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 55.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27532 CLTX TIBL FX PROX -MNPJ W/SKEL TRACJ", "code_information": [{"code": "27532", "type": "CPT"}, {"code": "101456", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6397.0, "discounted_cash": 1279.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27550 CLOSED TX KNEE DISLOCATION W/O ANESTHESIA", "code_information": [{"code": "27550", "type": "CPT"}, {"code": "101458", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1271.0, "discounted_cash": 254.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27552 CLOSED TX KNEE DISLOCATION W/ANESTHESIA", "code_information": [{"code": "27552", "type": "CPT"}, {"code": "101460", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6178.0, "discounted_cash": 1235.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27560 CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA", "code_information": [{"code": "27560", "type": "CPT"}, {"code": "101462", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1638.0, "discounted_cash": 327.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27562 CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA", "code_information": [{"code": "27562", "type": "CPT"}, {"code": "101464", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8659.0, "discounted_cash": 1731.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27599 UNLSTD PROC FEMUR OR KNEE", "code_information": [{"code": "27599", "type": "CPT"}, {"code": "181420", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6728.0, "discounted_cash": 1345.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27605 INCIS ACHILLES TENDON+LOCAL ANESTH", "code_information": [{"code": "27605", "type": "CPT"}, {"code": "178019", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1589.0, "discounted_cash": 317.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27648 INJECTION ANKLE ARTHROGRAPHY", "code_information": [{"code": "27648", "type": "CPT"}, {"code": "101478", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1536.0, "discounted_cash": 307.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27664 RPR EXTNSR TENDON,LEG;PRIM,EA", "code_information": [{"code": "27664", "type": "CPT"}, {"code": "175870", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 14357.0, "discounted_cash": 2871.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27750 CLTX TIBL SHFT FX W/O MNPJ", "code_information": [{"code": "27750", "type": "CPT"}, {"code": "101480", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 62.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27752 CLTX TIBL SHFT FX W/MNPJ -SKEL TRACJ", "code_information": [{"code": "27752", "type": "CPT"}, {"code": "101482", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2045.0, "discounted_cash": 409.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27760 CLTX MEDIAL MALLS FX W/O MNPJ", "code_information": [{"code": "27760", "type": "CPT"}, {"code": "101484", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1530.0, "discounted_cash": 306.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27762 CLTX MEDIAL MALLS FX W/MNPJ -SKN/SKEL TRACJ", "code_information": [{"code": "27762", "type": "CPT"}, {"code": "101486", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8368.0, "discounted_cash": 1673.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27768 CLTX POST ANKLE FX W/MNPJ", "code_information": [{"code": "27768", "type": "CPT"}, {"code": "176316", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6501.0, "discounted_cash": 1300.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27780 CLTX PROX FIBULA/SHFT FX W/O MNPJ", "code_information": [{"code": "27780", "type": "CPT"}, {"code": "101490", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1409.0, "discounted_cash": 281.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27781 CLST TMT PROX FIB/SHFT FX;W MANJ", "code_information": [{"code": "27781", "type": "CPT"}, {"code": "202739", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4732.0, "discounted_cash": 946.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MNPJ", "code_information": [{"code": "27786", "type": "CPT"}, {"code": "101492", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 367.0, "discounted_cash": 73.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27788 CLTX DSTL FIBULAR FX LAT MALLS W/MNPJ", "code_information": [{"code": "27788", "type": "CPT"}, {"code": "101494", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27808 CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MNPJ", "code_information": [{"code": "27808", "type": "CPT"}, {"code": "101496", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 55.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27810 CLOSED TX BIMALLEOLAR ANKLE FRACTURE W MNPJ", "code_information": [{"code": "27810", "type": "CPT"}, {"code": "101498", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1771.0, "discounted_cash": 354.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27816 CLTX TRIMAL ANKLE FX W/O MNPJ", "code_information": [{"code": "27816", "type": "CPT"}, {"code": "101500", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 61.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27818 CLTX TRIMAL ANKLE FX W/MNPJ", "code_information": [{"code": "27818", "type": "CPT"}, {"code": "101502", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2066.0, "discounted_cash": 413.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27824 CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MNPJ", "code_information": [{"code": "27824", "type": "CPT"}, {"code": "101504", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 65.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27825 CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ", "code_information": [{"code": "27825", "type": "CPT"}, {"code": "101506", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8368.0, "discounted_cash": 1673.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27830 CLTX PROX TIBFIB JT DISLC W/O ANES", "code_information": [{"code": "27830", "type": "CPT"}, {"code": "195928", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7886.0, "discounted_cash": 1577.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27831 CLTX PROX TIBFIB JT DISLC REQ ANES", "code_information": [{"code": "27831", "type": "CPT"}, {"code": "101508", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9725.0, "discounted_cash": 1945.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27840 CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA", "code_information": [{"code": "27840", "type": "CPT"}, {"code": "101510", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1603.0, "discounted_cash": 320.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 27842 CLTX ANKLE DISLC REQ ANES -PRQ SKEL FIXJ", "code_information": [{"code": "27842", "type": "CPT"}, {"code": "101512", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5786.0, "discounted_cash": 1157.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28001 INCISION&DRAINAGE BURSA FOOT", "code_information": [{"code": "28001", "type": "CPT"}, {"code": "101516", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4323.0, "discounted_cash": 864.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28005 INCISION BONE CORTEX FOOT", "code_information": [{"code": "28005", "type": "CPT"}, {"code": "101520", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4459.0, "discounted_cash": 891.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28010 TENOTOMY PERCUTANEOUS TOE SINGLE TENDON", "code_information": [{"code": "28010", "type": "CPT"}, {"code": "101522", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3198.0, "discounted_cash": 639.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28011 TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON", "code_information": [{"code": "28011", "type": "CPT"}, {"code": "101524", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1907.0, "discounted_cash": 381.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28043 EXCISION TUMOR FOOT SUBCUTANEOUS TISSUE", "code_information": [{"code": "28043", "type": "CPT"}, {"code": "101526", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2003.0, "discounted_cash": 400.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28045 EXC TUMOR FOOT DEEP SUBFASCIAL INTRAMUSCULAR", "code_information": [{"code": "28045", "type": "CPT"}, {"code": "101528", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2925.0, "discounted_cash": 585.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28092 EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA", "code_information": [{"code": "28092", "type": "CPT"}, {"code": "101534", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1907.0, "discounted_cash": 381.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28124 PRTL EXC B1 PHALANX TOE", "code_information": [{"code": "28124", "type": "CPT"}, {"code": "101540", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3656.0, "discounted_cash": 731.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28190 REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS", "code_information": [{"code": "28190", "type": "CPT"}, {"code": "101542", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1205.0, "discounted_cash": 241.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28192 REMOVAL FOREIGN BODY FOOT DEEP", "code_information": [{"code": "28192", "type": "CPT"}, {"code": "101544", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1798.0, "discounted_cash": 359.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28193 REMOVAL FOREIGN BODY FOOT COMPLICATED", "code_information": [{"code": "28193", "type": "CPT"}, {"code": "101546", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6708.0, "discounted_cash": 1341.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28208 RPR TENDON EXTENSOR FOOT 1/2 EA TENDON", "code_information": [{"code": "28208", "type": "CPT"}, {"code": "238017", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 10386.0, "discounted_cash": 2077.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28400 CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION", "code_information": [{"code": "28400", "type": "CPT"}, {"code": "101550", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28405 CLSD TX CALCANEAL FX; W/MNPJ", "code_information": [{"code": "28405", "type": "CPT"}, {"code": "194583", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1788.0, "discounted_cash": 357.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28430 CLOSED TX TALUS FRACTURE W/O MANIPULATION", "code_information": [{"code": "28430", "type": "CPT"}, {"code": "101552", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1409.0, "discounted_cash": 281.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28435 CLOSED TX TALUS FRACTURE W/ MANIPULATION", "code_information": [{"code": "28435", "type": "CPT"}, {"code": "101554", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1895.0, "discounted_cash": 379.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28450 TX TARSAL B1 FX XCP TALUS&CALCN W/O MNPJ", "code_information": [{"code": "28450", "type": "CPT"}, {"code": "101556", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1843.0, "discounted_cash": 368.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28450 TX TARSAL B1 FX XCP TALUS&CALCN W/O MNPJ", "code_information": [{"code": "28450", "type": "CPT"}, {"code": "191788", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 325.0, "discounted_cash": 65.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28470 CLOSED TX METATARSAL FRACTURE W/O MANIPULATION", "code_information": [{"code": "28470", "type": "CPT"}, {"code": "101560", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 278.0, "discounted_cash": 55.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28475 CLTX METAR FX W/MNPJ", "code_information": [{"code": "28475", "type": "CPT"}, {"code": "101562", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1823.0, "discounted_cash": 364.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28490 CLTX FX GRT TOE PHLX/PHLG W/O MNPJ", "code_information": [{"code": "28490", "type": "CPT"}, {"code": "101564", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 61.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28495 CLTX FX GRT TOE PHLX/PHLG W/MNPJ", "code_information": [{"code": "28495", "type": "CPT"}, {"code": "101566", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 987.0, "discounted_cash": 197.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28505 OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES", "code_information": [{"code": "28505", "type": "CPT"}, {"code": "101568", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 10386.0, "discounted_cash": 2077.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28510 CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MNPJ", "code_information": [{"code": "28510", "type": "CPT"}, {"code": "101570", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 278.0, "discounted_cash": 55.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28515 CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MNPJ", "code_information": [{"code": "28515", "type": "CPT"}, {"code": "101572", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 306.0, "discounted_cash": 61.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28530 CLOSED TREATMENT SESAMOID FRACTURE", "code_information": [{"code": "28530", "type": "CPT"}, {"code": "101574", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1409.0, "discounted_cash": 281.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28540 CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES", "code_information": [{"code": "28540", "type": "CPT"}, {"code": "101576", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1409.0, "discounted_cash": 281.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28570 CLOSED TX TALOTARSAL JOINT DISLC W/O ANES", "code_information": [{"code": "28570", "type": "CPT"}, {"code": "101578", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1409.0, "discounted_cash": 281.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28600 CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES", "code_information": [{"code": "28600", "type": "CPT"}, {"code": "101580", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1481.0, "discounted_cash": 296.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28630 CLTX METATARSOPHLNGL JT DISLC W/O ANES", "code_information": [{"code": "28630", "type": "CPT"}, {"code": "101582", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1048.0, "discounted_cash": 209.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28635 CLTX METATARSOPHLNGL JT DISLC REQ ANES", "code_information": [{"code": "28635", "type": "CPT"}, {"code": "101584", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6624.0, "discounted_cash": 1324.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28660 CLTX IPHAL JT DISLC W/O ANES", "code_information": [{"code": "28660", "type": "CPT"}, {"code": "101586", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28665 CLTX IPHAL JT DISLC REQ ANES", "code_information": [{"code": "28665", "type": "CPT"}, {"code": "101588", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3736.0, "discounted_cash": 747.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28675 OPEN TMT IPHAL JT DISLC", "code_information": [{"code": "28675", "type": "CPT"}, {"code": "180830", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8413.0, "discounted_cash": 1682.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28810 AMPUTATION METATARSAL W/TOE SINGLE", "code_information": [{"code": "28810", "type": "CPT"}, {"code": "101590", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3986.0, "discounted_cash": 797.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28820 AMPUTATION TOE METATARSOPHALANGEAL JOINT", "code_information": [{"code": "28820", "type": "CPT"}, {"code": "101592", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 4155.0, "discounted_cash": 831.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 28825 AMPUTATION TOE INTERPHALANGEAL JOINT", "code_information": [{"code": "28825", "type": "CPT"}, {"code": "101594", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3992.0, "discounted_cash": 798.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29065 APPLICATION CAST SHOULDER HAND LONG ARM", "code_information": [{"code": "29065", "type": "CPT"}, {"code": "101596", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 73.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29075 APPLICATION CAST ELBOW FINGER SHORT ARM", "code_information": [{"code": "29075", "type": "CPT"}, {"code": "101598", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 73.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29085 APPLICATION CAST HAND&LOWER FOREARM GAUNTLET", "code_information": [{"code": "29085", "type": "CPT"}, {"code": "101600", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 50.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29086 APPLICATION CAST FINGER", "code_information": [{"code": "29086", "type": "CPT"}, {"code": "226464", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 551.0, "discounted_cash": 110.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29105 APPLICATION LONG ARM SPLINT SHOULDER HAND", "code_information": [{"code": "29105", "type": "CPT"}, {"code": "101602", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 41.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29125 APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC", "code_information": [{"code": "29125", "type": "CPT"}, {"code": "101604", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 163.0, "discounted_cash": 32.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29126 APPLICATION SHORT ARM SPLINT DYNAMIC", "code_information": [{"code": "29126", "type": "CPT"}, {"code": "101606", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 707.0, "discounted_cash": 141.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29130 APPLICATION FINGER SPLINT STATIC", "code_information": [{"code": "29130", "type": "CPT"}, {"code": "101608", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 33.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29131 APPLICATION FINGER SPLINT DYNAMIC", "code_information": [{"code": "29131", "type": "CPT"}, {"code": "101610", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 650.0, "discounted_cash": 130.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29200 STRAPPING-THORAX", "code_information": [{"code": "29200", "type": "CPT"}, {"code": "101612", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 707.0, "discounted_cash": 141.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29240 STRAPPING-SHOULDER", "code_information": [{"code": "29240", "type": "CPT"}, {"code": "101614", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 767.0, "discounted_cash": 153.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29260 STRAPPING OF ELBOW OR WRIST", "code_information": [{"code": "29260", "type": "CPT"}, {"code": "101616", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 18.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29280 STRAPPING OF HAND OR FINGER", "code_information": [{"code": "29280", "type": "CPT"}, {"code": "101618", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 707.0, "discounted_cash": 141.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29345 APPLICATION OF LONG LEG CAST", "code_information": [{"code": "29345", "type": "CPT"}, {"code": "101620", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 73.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29355 APPLICATION OF LONG LEG CAST", "code_information": [{"code": "29355", "type": "CPT"}, {"code": "101622", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 73.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29405 APPLY SHORT LEG CAST,BLW KNEE", "code_information": [{"code": "29405", "type": "CPT"}, {"code": "101626", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 73.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29425 APPLY SHORT LEG CAST", "code_information": [{"code": "29425", "type": "CPT"}, {"code": "101628", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 73.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29445 APPLICATION TOTAL CONTACT CAST", "code_information": [{"code": "29445", "type": "CPT"}, {"code": "101630", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 378.0, "discounted_cash": 75.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29505 APPLICATION, LONG LEG SPLINT", "code_information": [{"code": "29505", "type": "CPT"}, {"code": "101632", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 41.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29515 APPLICATION LOWER LEG SPLINT", "code_information": [{"code": "29515", "type": "CPT"}, {"code": "101634", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 41.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29530 STRAPPING OF KNEE", "code_information": [{"code": "29530", "type": "CPT"}, {"code": "101636", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 902.0, "discounted_cash": 180.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29540 STRAPPING OF ANKLE AND/OR FT", "code_information": [{"code": "29540", "type": "CPT"}, {"code": "101638", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 41.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29550 STRAPPING OF TOES", "code_information": [{"code": "29550", "type": "CPT"}, {"code": "101640", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 18.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29580 APPLICATION OF PASTE BOOT UNNA", "code_information": [{"code": "29580", "type": "CPT"}, {"code": "101642", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 41.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29581 APP MULTI-LAYER VENOUS COMPRESS", "code_information": [{"code": "29581", "type": "CPT"}, {"code": "101644", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 41.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29700 REM OR BIVALV,BOOT/BODY CAST", "code_information": [{"code": "29700", "type": "CPT"}, {"code": "101646", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 707.0, "discounted_cash": 141.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29705 REMOVE/BIVALVE LG ARMS/LEG", "code_information": [{"code": "29705", "type": "CPT"}, {"code": "101648", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 707.0, "discounted_cash": 141.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29720 REPAIR OF BODY CAST/SPICA", "code_information": [{"code": "29720", "type": "CPT"}, {"code": "101650", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 707.0, "discounted_cash": 141.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29730 WINDOWING OF CAST", "code_information": [{"code": "29730", "type": "CPT"}, {"code": "101652", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 707.0, "discounted_cash": 141.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29740 WEDGING OF CAST", "code_information": [{"code": "29740", "type": "CPT"}, {"code": "101654", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 707.0, "discounted_cash": 141.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29799 UNLSD PROC CASTING/STRAPPING", "code_information": [{"code": "29799", "type": "CPT"}, {"code": "101656", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 772.0, "discounted_cash": 154.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 29805 DX ARTHROSCOPY SHLDR -SYNOVIAL BX SPX", "code_information": [{"code": "29805", "type": "CPT"}, {"code": "187192", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2736.0, "discounted_cash": 547.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 30000 DRAIN ABSCESS/HEMAT,NASAL", "code_information": [{"code": "30000", "type": "CPT"}, {"code": "101662", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1477.0, "discounted_cash": 295.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 30020 DRAIN NASAL ABSCESS/HEMATOMA", "code_information": [{"code": "30020", "type": "CPT"}, {"code": "101664", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1079.0, "discounted_cash": 215.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 30100 INTRANASAL BIOPSY", "code_information": [{"code": "30100", "type": "CPT"}, {"code": "101666", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2166.0, "discounted_cash": 433.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 30300 REMOVE NASAL FOREIGN BODY", "code_information": [{"code": "30300", "type": "CPT"}, {"code": "101672", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 29.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 30901 CONTROL NASAL HEMORRHAGE SIMPL", "code_information": [{"code": "30901", "type": "CPT"}, {"code": "101680", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 33.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 30903 CONTROL NASAL HEMOR ANT CMPLX", "code_information": [{"code": "30903", "type": "CPT"}, {"code": "101682", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 202.0, "discounted_cash": 40.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 30905 CONTROL NASAL HEM POST INITIAL", "code_information": [{"code": "30905", "type": "CPT"}, {"code": "101684", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1921.0, "discounted_cash": 384.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 30906 CONTROL NASAL HEM POST SUBSQNT", "code_information": [{"code": "30906", "type": "CPT"}, {"code": "101686", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 60.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 30999 UNLISTED NASAL PROCEDURE", "code_information": [{"code": "30999", "type": "CPT"}, {"code": "101688", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 781.0, "discounted_cash": 156.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31231 NASAL ENDOSCOPY, DX", "code_information": [{"code": "31231", "type": "CPT"}, {"code": "101690", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 42.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31237 NASAL/SINUS ENDOSCOPY, SURG", "code_information": [{"code": "31237", "type": "CPT"}, {"code": "101692", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1491.0, "discounted_cash": 298.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31238 NASAL/SINUS ENDOSCOPY, SURG", "code_information": [{"code": "31238", "type": "CPT"}, {"code": "101694", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1775.0, "discounted_cash": 355.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31299 UNL PROCED, ACCESSORY SINUS", "code_information": [{"code": "31299", "type": "CPT"}, {"code": "101696", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1058.0, "discounted_cash": 211.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31299 UNLSTD PROCEDURE ACCESSORY SINUSES", "code_information": [{"code": "31299", "type": "CPT"}, {"code": "202521", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6821.0, "discounted_cash": 1364.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31500 INTUBATE ENDOTRACHEAL EMERGENT", "code_information": [{"code": "31500", "type": "CPT"}, {"code": "194286", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1287.0, "discounted_cash": 257.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31500 INTUBATE ENDOTRACHEAL EMERGENT", "code_information": [{"code": "31500", "type": "CPT"}, {"code": "194290", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1287.0, "discounted_cash": 257.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31500 INTUBATION, ENDOTRACHEAL, EMER", "code_information": [{"code": "31500", "type": "CPT"}, {"code": "101698", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1287.0, "discounted_cash": 257.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31502 TRACH TUBE CHG BEFORE FIS TRAC", "code_information": [{"code": "31502", "type": "CPT"}, {"code": "101700", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1295.0, "discounted_cash": 259.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31528 LARYNGOSCOPY W/DILAT INITIAL", "code_information": [{"code": "31528", "type": "CPT"}, {"code": "199512", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5874.0, "discounted_cash": 1174.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31575 LARYNGOSCOPY,FLEX,DIAGNOSTIC", "code_information": [{"code": "31575", "type": "CPT"}, {"code": "101712", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 42.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31579 LARYNGOSCOPY WITH STROBOSCOPY", "code_information": [{"code": "31579", "type": "CPT"}, {"code": "212100", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 406.0, "discounted_cash": 81.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31599 UNLSTD PX LARYNX", "code_information": [{"code": "31599", "type": "CPT"}, {"code": "199508", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4032.0, "discounted_cash": 806.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31600 TRACHEOSTOMY PLANNED SPX", "code_information": [{"code": "31600", "type": "CPT"}, {"code": "101718", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7464.0, "discounted_cash": 1492.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31603 TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL", "code_information": [{"code": "31603", "type": "CPT"}, {"code": "101720", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1946.0, "discounted_cash": 389.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31605 TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE", "code_information": [{"code": "31605", "type": "CPT"}, {"code": "101722", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4633.0, "discounted_cash": 926.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31615 TRACHEOBRONCHOSCOPY,ESTB TRACH", "code_information": [{"code": "31615", "type": "CPT"}, {"code": "177519", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 95.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31622 BRNCHSC DX -CELL WASHG SPX", "code_information": [{"code": "31622", "type": "CPT"}, {"code": "101728", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4022.0, "discounted_cash": 804.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31623 BRNCHSC BRUSHING/PROTECTED BRUSHINGS", "code_information": [{"code": "31623", "type": "CPT"}, {"code": "101730", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4255.0, "discounted_cash": 851.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31624 BRNCHSC W/BRNCL ALVEOLAR LAVAGE", "code_information": [{"code": "31624", "type": "CPT"}, {"code": "101732", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3477.0, "discounted_cash": 695.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31625 BRNCHSC BRNCL/ENDOBRNCL BX 1 SITS", "code_information": [{"code": "31625", "type": "CPT"}, {"code": "101734", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4995.0, "discounted_cash": 999.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31626 BRNCHSC W/PLCMNT OF FIDUICIAL MARKERS", "code_information": [{"code": "31626", "type": "CPT"}, {"code": "186189", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5258.0, "discounted_cash": 1051.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31627 NAVGTNL BRNCHSC W IMG GDE", "code_information": [{"code": "31627", "type": "CPT"}, {"code": "175990", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3653.0, "discounted_cash": 730.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31628 BRNCHSC W/TRANSBRNCL LUNG BX 1 LOBE", "code_information": [{"code": "31628", "type": "CPT"}, {"code": "101736", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3917.0, "discounted_cash": 783.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31629 BRNCHSC NDL BX TRACHEA MAIN STEM&/BRONCHUSI", "code_information": [{"code": "31629", "type": "CPT"}, {"code": "101738", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3649.0, "discounted_cash": 729.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31630 BRNCHSC W DILATION OR FX REPR", "code_information": [{"code": "31630", "type": "CPT"}, {"code": "177521", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5968.0, "discounted_cash": 1193.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31631 BRNCHSC W PLCMNT STENT(INCL DILATION)", "code_information": [{"code": "31631", "type": "CPT"}, {"code": "177523", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9519.0, "discounted_cash": 1903.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31632 BRNCHSC W/TRANSBRNCL LUNG BX EA ADDL LOBE", "code_information": [{"code": "31632", "type": "CPT"}, {"code": "101744", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3774.0, "discounted_cash": 754.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31633 BRNCHSC W/TRANSBRNCL NDL ASPIR BX EA ADDL LOBE", "code_information": [{"code": "31633", "type": "CPT"}, {"code": "101746", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3649.0, "discounted_cash": 729.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31634 BRONCHSC W/BALLOON OCCLUSION", "code_information": [{"code": "31634", "type": "CPT"}, {"code": "194310", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 10881.0, "discounted_cash": 2176.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31635 BRONCH; WITH REMOVAL FB", "code_information": [{"code": "31635", "type": "CPT"}, {"code": "162838", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4737.0, "discounted_cash": 947.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31636 BRONCHSC W BRONCH STENTS", "code_information": [{"code": "31636", "type": "CPT"}, {"code": "194314", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 11425.0, "discounted_cash": 2285.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31641 BRNCHSC DSTRJ TUM OTH/THN EXC", "code_information": [{"code": "31641", "type": "CPT"}, {"code": "177386", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8673.0, "discounted_cash": 1734.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31645 BRNCHSC THERAPEUTIC ASP TRACH TREE,INI", "code_information": [{"code": "31645", "type": "CPT"}, {"code": "184517", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4251.0, "discounted_cash": 850.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31647 BRONCHSC W/ VLVE INS INIT LOBE", "code_information": [{"code": "31647", "type": "CPT"}, {"code": "194322", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 10881.0, "discounted_cash": 2176.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31648 BRONCHSC W/ VLVE REM INIT LOBE", "code_information": [{"code": "31648", "type": "CPT"}, {"code": "194326", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6191.0, "discounted_cash": 1238.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31649 BRNCHSC RMVL VALVE(S) EA ADDL LOBE", "code_information": [{"code": "31649", "type": "CPT"}, {"code": "194330", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4968.0, "discounted_cash": 993.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31652 BRONCH EBUS SAMPLNG 1/2 NODE", "code_information": [{"code": "31652", "type": "CPT"}, {"code": "181458", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4941.0, "discounted_cash": 988.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31653 BRONCH EBUS SAMPLNG 3/> NODE", "code_information": [{"code": "31653", "type": "CPT"}, {"code": "181460", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6174.0, "discounted_cash": 1234.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31654 BRONCH EBUS IVNTJ PERPH LES", "code_information": [{"code": "31654", "type": "CPT"}, {"code": "181462", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4098.0, "discounted_cash": 819.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 31720 CATHETER ASPIRATION NASOTRACHEAL SPX", "code_information": [{"code": "31720", "type": "CPT"}, {"code": "101750", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 529.0, "discounted_cash": 105.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32100 THORACOTOMY; WITH EXPLORATION", "code_information": [{"code": "32100", "type": "CPT"}, {"code": "180981", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6063.0, "discounted_cash": 1212.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32160 THORACOTOMY; W CARDIAC MASSAGE", "code_information": [{"code": "32160", "type": "CPT"}, {"code": "175919", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 15191.0, "discounted_cash": 3038.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32400 BIOPSY PLEURA, PRQ NEEDLE", "code_information": [{"code": "32400", "type": "CPT"}, {"code": "175915", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2571.0, "discounted_cash": 514.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32408 CORE NDL BX LNG/MED PERQ", "code_information": [{"code": "32408", "type": "CPT"}, {"code": "230901", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2575.0, "discounted_cash": 515.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32550 INSERTION INDWELLING TUNNELED PLEURAL CATHETER", "code_information": [{"code": "32550", "type": "CPT"}, {"code": "101768", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5010.0, "discounted_cash": 1002.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32551 TUBE THORACOSTOMY INCLUDES WATER SEAL", "code_information": [{"code": "32551", "type": "CPT"}, {"code": "101770", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3916.0, "discounted_cash": 783.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32554 THORACENTESIS NDL/CATH,ASP PLRL SP", "code_information": [{"code": "32554", "type": "CPT"}, {"code": "273781", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 853.0, "discounted_cash": 170.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32555 THORACENTESIS NDL/CATH,ASP PLRL SP; W/IMG GUIDE", "code_information": [{"code": "32555", "type": "CPT"}, {"code": "273777", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 914.0, "discounted_cash": 182.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32556 INSERT CATH PLEURA W/O IMAGE", "code_information": [{"code": "32556", "type": "CPT"}, {"code": "180180", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2566.0, "discounted_cash": 513.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32557 PRQ DRN PLEURAL FLD,W/INSRT INDWL CATH", "code_information": [{"code": "32557", "type": "CPT"}, {"code": "175913", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2776.0, "discounted_cash": 555.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32650 THORACOSCOPY SURGICAL W/PLEURODESIS", "code_information": [{"code": "32650", "type": "CPT"}, {"code": "177525", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11817.0, "discounted_cash": 2363.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32994 ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATN", "code_information": [{"code": "32994", "type": "CPT"}, {"code": "383204", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 10151.0, "discounted_cash": 2030.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 32998 ABLTJ PULMONARY TUM(S) PERQ RF UNI", "code_information": [{"code": "32998", "type": "CPT"}, {"code": "101778", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 10419.0, "discounted_cash": 2083.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33016 PERICARDIOCENTESIS W/IMG GDE WHEN PERFORMED", "code_information": [{"code": "33016", "type": "CPT"}, {"code": "214825", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7199.0, "discounted_cash": 1439.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33017 PRCRD DRG 6YR+ W/O CONG CAR ANOM, INCL FLUORO/US", "code_information": [{"code": "33017", "type": "CPT"}, {"code": "214827", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9675.0, "discounted_cash": 1935.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33018 PRCRD DRG 0-5YR OR W/CONG CAR ANOM, INCL FLUORO/US", "code_information": [{"code": "33018", "type": "CPT"}, {"code": "214829", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9675.0, "discounted_cash": 1935.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33206 INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD ATR", "code_information": [{"code": "33206", "type": "CPT"}, {"code": "101786", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10512.0, "discounted_cash": 2102.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33207 INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD VENTR", "code_information": [{"code": "33207", "type": "CPT"}, {"code": "101788", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12965.0, "discounted_cash": 2593.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33208 INSJ/RPLCMT PRM PM W/TRANSVNS ELTRD ATR&VENTR", "code_information": [{"code": "33208", "type": "CPT"}, {"code": "101790", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12965.0, "discounted_cash": 2593.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33210 INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH", "code_information": [{"code": "33210", "type": "CPT"}, {"code": "101792", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8630.0, "discounted_cash": 1726.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33212 INS PPM GEN W/EXIST SINGL LEAD", "code_information": [{"code": "33212", "type": "CPT"}, {"code": "101796", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 22034.0, "discounted_cash": 4406.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33213 INS PPM GEN W/EXIST DUAL LEAD", "code_information": [{"code": "33213", "type": "CPT"}, {"code": "101798", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 28108.0, "discounted_cash": 5621.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33214 UPG PM SYS CONV 1CHMBR SYS 2CHMBR SYS", "code_information": [{"code": "33214", "type": "CPT"}, {"code": "101800", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10897.0, "discounted_cash": 2179.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33215 REPOSITION RA/RV LEAD PPM/ICD", "code_information": [{"code": "33215", "type": "CPT"}, {"code": "186193", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8874.0, "discounted_cash": 1774.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33216 INSERT SINGLE LEAD PPM/ICD", "code_information": [{"code": "33216", "type": "CPT"}, {"code": "102119", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9351.0, "discounted_cash": 1870.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33217 INSERT DUAL LEAD PPM/ICD", "code_information": [{"code": "33217", "type": "CPT"}, {"code": "102117", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9947.0, "discounted_cash": 1989.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33218 REPAIR LEAD SINGLE PPM/ICD", "code_information": [{"code": "33218", "type": "CPT"}, {"code": "186195", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8874.0, "discounted_cash": 1774.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33220 REPAIR LEADS DUAL PPM/ICD", "code_information": [{"code": "33220", "type": "CPT"}, {"code": "186197", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8343.0, "discounted_cash": 1668.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33221 INSERT PPM GEN W/EXIST MULT LEADS", "code_information": [{"code": "33221", "type": "CPT"}, {"code": "152894", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 29357.0, "discounted_cash": 5871.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33222 RELOCATE SKIN POCKET PPM", "code_information": [{"code": "33222", "type": "CPT"}, {"code": "186199", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10774.0, "discounted_cash": 2154.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33223 RELOCATE SKN POCKT AICD", "code_information": [{"code": "33223", "type": "CPT"}, {"code": "186201", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10774.0, "discounted_cash": 2154.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33224 INSJ ELTRD CAR VEN SYS ATTCH PM/CVDFB PLS GEN", "code_information": [{"code": "33224", "type": "CPT"}, {"code": "101802", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2424.0, "discounted_cash": 484.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33225 LT VENT LEAD PLMNT W/PKT REV", "code_information": [{"code": "33225", "type": "CPT"}, {"code": "101804", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8885.0, "discounted_cash": 1777.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33226 RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD", "code_information": [{"code": "33226", "type": "CPT"}, {"code": "101806", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5368.0, "discounted_cash": 1073.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33227 RMVL/REPL PPM GEN, SINGLE LEAD", "code_information": [{"code": "33227", "type": "CPT"}, {"code": "152896", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 26783.0, "discounted_cash": 5356.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33228 RMVL/REPL PPM GEN, DUAL LEAD", "code_information": [{"code": "33228", "type": "CPT"}, {"code": "152898", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 29357.0, "discounted_cash": 5871.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33229 RMVL/REPL PPM GEN, MULTI LEAD", "code_information": [{"code": "33229", "type": "CPT"}, {"code": "152900", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 29357.0, "discounted_cash": 5871.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33230 INS ICD GEN W/EXIST DUAL LEADS", "code_information": [{"code": "33230", "type": "CPT"}, {"code": "152902", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 60861.0, "discounted_cash": 12172.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33231 INS ICD GEN W/EXIST MULT LEADS", "code_information": [{"code": "33231", "type": "CPT"}, {"code": "152904", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 60861.0, "discounted_cash": 12172.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33233 REMOVAL PPM GENERATOR ONLY", "code_information": [{"code": "33233", "type": "CPT"}, {"code": "152906", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10810.0, "discounted_cash": 2162.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33234 RMVL TRANSVNS PM ELCTR(S);SNGL LEAD SYS,ATR/VENTR", "code_information": [{"code": "33234", "type": "CPT"}, {"code": "189039", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9100.0, "discounted_cash": 1820.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33235 REMOVAL PACEMAKER ELECTRODE(S), DUAL LEAD", "code_information": [{"code": "33235", "type": "CPT"}, {"code": "189043", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11188.0, "discounted_cash": 2237.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33240 INS ICD GEN W/EXIST SINGL LEAD", "code_information": [{"code": "33240", "type": "CPT"}, {"code": "101810", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 41084.0, "discounted_cash": 8216.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33241 SUBQ RMVL 1/2CHMBR PACG CVDFB PLS GEN", "code_information": [{"code": "33241", "type": "CPT"}, {"code": "101812", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12536.0, "discounted_cash": 2507.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33244 RMVL 1/2CHMBR PACG CVDFB ELTRD TRANSVNS XTRJ", "code_information": [{"code": "33244", "type": "CPT"}, {"code": "101814", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9705.0, "discounted_cash": 1941.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33249 INSJ/RPSG LEAD 1/2CHMBR CVDFB&INSJ PLS GEN", "code_information": [{"code": "33249", "type": "CPT"}, {"code": "101816", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 49289.0, "discounted_cash": 9857.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33262 RMVL/REPL ICD GEN, SINGLE LEAD", "code_information": [{"code": "33262", "type": "CPT"}, {"code": "152908", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 60861.0, "discounted_cash": 12172.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33263 RMVL/REPL ICD GEN, DUAL LEAD", "code_information": [{"code": "33263", "type": "CPT"}, {"code": "152910", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 60861.0, "discounted_cash": 12172.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33264 RMVL/REPL ICD GEN, MULTI LEAD", "code_information": [{"code": "33264", "type": "CPT"}, {"code": "152912", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 60861.0, "discounted_cash": 12172.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33270 INS/REPL PRM SQ IMPLT DFIB W/SQ ELECTRODE", "code_information": [{"code": "33270", "type": "CPT"}, {"code": "179935", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39414.0, "discounted_cash": 7882.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33272 RMVL SUBQ DEFIBRILLATOR ELECTRODE", "code_information": [{"code": "33272", "type": "CPT"}, {"code": "180060", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9705.0, "discounted_cash": 1941.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33273 REPOSITION SUBQ DEFIB ELECTRODE, PREV IMPLT", "code_information": [{"code": "33273", "type": "CPT"}, {"code": "199968", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9705.0, "discounted_cash": 1941.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33274 TRNSCTH INSJ/RPLC PERM LDLS PM RT VENTR W/IMG", "code_information": [{"code": "33274", "type": "CPT"}, {"code": "200054", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 34496.0, "discounted_cash": 6899.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33275 TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG", "code_information": [{"code": "33275", "type": "CPT"}, {"code": "228143", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6761.0, "discounted_cash": 1352.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33276 INSERTION PHRENIC NERVE STIMULATOR SYSTEM", "code_information": [{"code": "33276", "type": "CPT"}, {"code": "297070", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 94502.0, "discounted_cash": 18900.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33277 INSJ PHRENIC NRV STIMULATOR TRANSVNS SENSING LD", "code_information": [{"code": "33277", "type": "CPT"}, {"code": "297072", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 48.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33278 REMOVAL PHRENIC NERVE STIMULATOR SYSTEM", "code_information": [{"code": "33278", "type": "CPT"}, {"code": "297074", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 6808.0, "discounted_cash": 1361.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33279 RMVL PHRNC NRV STIMULATOR TRANSVNS STIMJ/SNSG LD", "code_information": [{"code": "33279", "type": "CPT"}, {"code": "297076", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 6808.0, "discounted_cash": 1361.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33280 RMVL PHRENIC NRV STIMULATOR PULSE GENERATOR ONLY", "code_information": [{"code": "33280", "type": "CPT"}, {"code": "297078", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 6808.0, "discounted_cash": 1361.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33281 REPOSITIONING PHRENIC NRV STIMULATOR TRANSVNS LD", "code_information": [{"code": "33281", "type": "CPT"}, {"code": "297084", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 6808.0, "discounted_cash": 1361.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33285 INSJ SUBQ CARD RHYTHM MNTR W/PRGRMG", "code_information": [{"code": "33285", "type": "CPT"}, {"code": "200056", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2005.0, "discounted_cash": 401.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33286 RMVL SUBQ CARD RHYTHM MNTR", "code_information": [{"code": "33286", "type": "CPT"}, {"code": "200058", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1306.0, "discounted_cash": 261.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33287 RMVL&RPLCMT PHRENIC NRV STIMULATOR PLS GENERATOR", "code_information": [{"code": "33287", "type": "CPT"}, {"code": "297080", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 62132.0, "discounted_cash": 12426.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33288 RMVL&RPLCMT PHRNC NRV STIM TRNSVNS STIMJ/SNSG LD", "code_information": [{"code": "33288", "type": "CPT"}, {"code": "297082", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 27256.0, "discounted_cash": 5451.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33289 TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR", "code_information": [{"code": "33289", "type": "CPT"}, {"code": "178171", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 69538.0, "discounted_cash": 13907.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33340 PERQ CLSR TCAT L ATR APNDGE W ENDOCARD IMPL", "code_information": [{"code": "33340", "type": "CPT"}, {"code": "186608", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 62281.0, "discounted_cash": 12456.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33340 WAVECREST PROCEDURE", "code_information": [{"code": "33340", "type": "CPT"}, {"code": "202133", "type": "CDM"}, {"code": "990", "type": "RC"}], "standard_charges": [{"gross_charge": 13000.0, "discounted_cash": 2600.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33418 TCAT MITRAL VALVE RPR INITIAL PROSTHESIS", "code_information": [{"code": "33418", "type": "CPT"}, {"code": "236292", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 20966.0, "discounted_cash": 4193.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33419 TCAT MITRAL VALVE RPR ADD'L PROSTHESIS", "code_information": [{"code": "33419", "type": "CPT"}, {"code": "236294", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 5990.0, "discounted_cash": 1198.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33967 INSERTION INTRA-AORTIC BALLOON ASSIST DEV PRQ", "code_information": [{"code": "33967", "type": "CPT"}, {"code": "101818", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8890.0, "discounted_cash": 1778.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33990 INSJ PERQ VAD W/IMG ARTERY ACCESS ONLY", "code_information": [{"code": "33990", "type": "CPT"}, {"code": "176261", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 38920.0, "discounted_cash": 7784.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33993 REPOSITION VAD W/IMG DIFF SESSION", "code_information": [{"code": "33993", "type": "CPT"}, {"code": "176269", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14585.0, "discounted_cash": 2917.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33999 OPTIMIZER SYSTEM IMPLANT(G030099)", "code_information": [{"code": "33999", "type": "CPT"}, {"code": "177360", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 26447.0, "discounted_cash": 5289.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 33999 PERC LT ATRIAL APPENDAGE LIG W/SUTURE", "code_information": [{"code": "33999", "type": "CPT"}, {"code": "298527", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 24951.0, "discounted_cash": 4990.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 34201 EMBLC/THRMBC FEMPOP A-ILIAC ART", "code_information": [{"code": "34201", "type": "CPT"}, {"code": "101820", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10723.0, "discounted_cash": 2144.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 34701 EVASC RPR DPLMNT AORTO-AORTIC NDGFT", "code_information": [{"code": "34701", "type": "CPT"}, {"code": "182880", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12040.0, "discounted_cash": 2408.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 34703 EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT", "code_information": [{"code": "34703", "type": "CPT"}, {"code": "182882", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13203.0, "discounted_cash": 2640.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 34705 EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT", "code_information": [{"code": "34705", "type": "CPT"}, {"code": "182884", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13203.0, "discounted_cash": 2640.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 34707 EVASC RPR DPLMNT ILIO-ILIAC NDGFT", "code_information": [{"code": "34707", "type": "CPT"}, {"code": "182886", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13203.0, "discounted_cash": 2640.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 34709 PLCMNT XTN PROSTH FOR ENDOVASCULAR RPR", "code_information": [{"code": "34709", "type": "CPT"}, {"code": "182888", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1793.0, "discounted_cash": 358.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 35207 REPAIR BLOOD VESSEL DIRECT HAND FINGER", "code_information": [{"code": "35207", "type": "CPT"}, {"code": "101824", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7379.0, "discounted_cash": 1475.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 35221 RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL", "code_information": [{"code": "35221", "type": "CPT"}, {"code": "210199", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7409.0, "discounted_cash": 1481.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 35226 RPR BLOOD VESSEL DIRECT LOWER EXTREMITY", "code_information": [{"code": "35226", "type": "CPT"}, {"code": "101826", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4812.0, "discounted_cash": 962.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 35860 EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR", "code_information": [{"code": "35860", "type": "CPT"}, {"code": "101838", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 10887.0, "discounted_cash": 2177.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36000 INTRODUCTION NEEDLE/INTRACATHETER VEIN", "code_information": [{"code": "36000", "type": "CPT"}, {"code": "189261", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1330.0, "discounted_cash": 266.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36002 NJX PX PRQ TX XTR PSEUDOARYSM", "code_information": [{"code": "36002", "type": "CPT"}, {"code": "101842", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1135.0, "discounted_cash": 227.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36005 NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH", "code_information": [{"code": "36005", "type": "CPT"}, {"code": "101844", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 3535.0, "discounted_cash": 707.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36010 INTRO CATH SUPRIOR/IVC", "code_information": [{"code": "36010", "type": "CPT"}, {"code": "101846", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 2500.0, "discounted_cash": 500.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36011 SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH", "code_information": [{"code": "36011", "type": "CPT"}, {"code": "101848", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 2791.0, "discounted_cash": 558.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36012 SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANCH", "code_information": [{"code": "36012", "type": "CPT"}, {"code": "101850", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 3139.0, "discounted_cash": 627.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36013 INTRO CATH R HRT/MAIN P-ART", "code_information": [{"code": "36013", "type": "CPT"}, {"code": "101852", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1151.0, "discounted_cash": 230.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36014 SLCTV CATH PLMT L/R P-ART", "code_information": [{"code": "36014", "type": "CPT"}, {"code": "101854", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 2856.0, "discounted_cash": 571.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36015 SLCTV CATH PLMT SGMTL/SUBSGMTL P-ART", "code_information": [{"code": "36015", "type": "CPT"}, {"code": "101856", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2786.0, "discounted_cash": 557.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36140 INTRO NDL/INTRACATH UPPR/LWR XTR ART", "code_information": [{"code": "36140", "type": "CPT"}, {"code": "101862", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 2473.0, "discounted_cash": 494.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36200 INTRO CATH AORTA", "code_information": [{"code": "36200", "type": "CPT"}, {"code": "101870", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 2918.0, "discounted_cash": 583.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36215 SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH", "code_information": [{"code": "36215", "type": "CPT"}, {"code": "101872", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 3348.0, "discounted_cash": 669.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36216 SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH", "code_information": [{"code": "36216", "type": "CPT"}, {"code": "101874", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 4857.0, "discounted_cash": 971.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36217 SLCTV CATHJ 3RD ORD SLCTV THRC/BRCH/CPHLC BRNCH", "code_information": [{"code": "36217", "type": "CPT"}, {"code": "101876", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 5215.0, "discounted_cash": 1043.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36218 SLCTV CATHJ EA 2ND ORD THRC/BRCH/CPHLC BRNCH", "code_information": [{"code": "36218", "type": "CPT"}, {"code": "101878", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 2628.0, "discounted_cash": 525.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36221 NON SEL CATH PLMT THOR AORTA,ANGIO UNI OR BILAT", "code_information": [{"code": "36221", "type": "CPT"}, {"code": "273795", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14588.0, "discounted_cash": 2917.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36222 CATH PLMT CAR/INOM ART,ANGIO CERV ARCH", "code_information": [{"code": "36222", "type": "CPT"}, {"code": "273797", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14588.0, "discounted_cash": 2917.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36223 CATH PLMT CAR/INOM ART,ANGIO EXT CAR/CERV ARCH", "code_information": [{"code": "36223", "type": "CPT"}, {"code": "273799", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14588.0, "discounted_cash": 2917.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36224 CATH PLMT INTRNL CAR ART,ANGIO CERV ARCH", "code_information": [{"code": "36224", "type": "CPT"}, {"code": "273801", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14588.0, "discounted_cash": 2917.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36225 CATH PLMT SUBCLAVIAN ART,ANGIO CERV ARCH", "code_information": [{"code": "36225", "type": "CPT"}, {"code": "273803", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14588.0, "discounted_cash": 2917.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36226 CATH PLMT VERTEBRAL ART,ANGIO CERV ARCH", "code_information": [{"code": "36226", "type": "CPT"}, {"code": "273805", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14588.0, "discounted_cash": 2917.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36227 CATH PLMT XTRNL CAROTID,ANGIO", "code_information": [{"code": "36227", "type": "CPT"}, {"code": "273807", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 14588.0, "discounted_cash": 2917.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36228 CATH PLMT INTRACRANIAL ART,ANGIO", "code_information": [{"code": "36228", "type": "CPT"}, {"code": "186217", "type": "CDM"}, {"code": "323", "type": "RC"}], "standard_charges": [{"gross_charge": 11607.0, "discounted_cash": 2321.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36245 SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH", "code_information": [{"code": "36245", "type": "CPT"}, {"code": "101880", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 3783.0, "discounted_cash": 756.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36246 SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH", "code_information": [{"code": "36246", "type": "CPT"}, {"code": "101882", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 4857.0, "discounted_cash": 971.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36247 SLCTV CATHJ 3RD ORD SLCTV ABDL PEL/LXTR BRNCH", "code_information": [{"code": "36247", "type": "CPT"}, {"code": "101884", "type": "CDM"}, {"code": "481", "type": "RC"}], "standard_charges": [{"gross_charge": 5215.0, "discounted_cash": 1043.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36248 SLCTV CATHJ EA 2ND ORD ABDL PEL/LXTR ART BRNCH", "code_information": [{"code": "36248", "type": "CPT"}, {"code": "101886", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1751.0, "discounted_cash": 350.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36251 SELECT CATH PLCMNT RENAL UNI", "code_information": [{"code": "36251", "type": "CPT"}, {"code": "152914", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19936.0, "discounted_cash": 3987.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36252 SELECT CATH PLCMNT RENAL BILAT", "code_information": [{"code": "36252", "type": "CPT"}, {"code": "152916", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19936.0, "discounted_cash": 3987.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36253 SUPRSEL CATH PLMNT RENAL UNI", "code_information": [{"code": "36253", "type": "CPT"}, {"code": "152918", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19936.0, "discounted_cash": 3987.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36254 SUPRSEL CATH PLMNT RENAL BIL", "code_information": [{"code": "36254", "type": "CPT"}, {"code": "152920", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19936.0, "discounted_cash": 3987.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36400 VNPNXR <3 YEARS PHYS SKILL FEM/JUG VEIN", "code_information": [{"code": "36400", "type": "CPT"}, {"code": "101890", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 123.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36405 VNPNXR <3 YEARS PHYS SKILL SCALP VEIN", "code_information": [{"code": "36405", "type": "CPT"}, {"code": "101892", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 123.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36406 VNPNXR <3 YEARS PHYS SKILL OTHER VEIN", "code_information": [{"code": "36406", "type": "CPT"}, {"code": "101894", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 616.0, "discounted_cash": 123.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36410 VNPNXR 3 YEARS/> PHYS SKILL", "code_information": [{"code": "36410", "type": "CPT"}, {"code": "101896", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 636.0, "discounted_cash": 127.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36415 COLLJ VEN BLD VNPNXR", "code_information": [{"code": "36415", "type": "CPT"}, {"code": "101898", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 8.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36416 COLLJ CAPILLARY BLD SPEC", "code_information": [{"code": "36416", "type": "CPT"}, {"code": "101900", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 30.0, "discounted_cash": 6.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36420 VNPNXR CUTDOWN UNDER AGE 1 YR", "code_information": [{"code": "36420", "type": "CPT"}, {"code": "101902", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 32.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36430 ADMIN BLOOD TRANSFUSION PER VISIT", "code_information": [{"code": "36430", "type": "CPT"}, {"code": "101906", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 2713.0, "discounted_cash": 542.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36440 PUSH BLD TRANSFUSION 2 & UNDER", "code_information": [{"code": "36440", "type": "CPT"}, {"code": "101909", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2261.0, "discounted_cash": 452.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36450 EXCHANGE TRANSFSN, BLD; NEWBORN", "code_information": [{"code": "36450", "type": "CPT"}, {"code": "180337", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 1865.0, "discounted_cash": 373.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36456 PRTL EXCHANGE TRANSFSN, BLD; NEWBORN", "code_information": [{"code": "36456", "type": "CPT"}, {"code": "190469", "type": "CDM"}, {"code": "391", "type": "RC"}], "standard_charges": [{"gross_charge": 1865.0, "discounted_cash": 373.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36465 NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEI", "code_information": [{"code": "36465", "type": "CPT"}, {"code": "188196", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2304.0, "discounted_cash": 460.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36470 INJ SCLEROSANT SINGLE INCMPTNT VEIN", "code_information": [{"code": "36470", "type": "CPT"}, {"code": "101911", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 116.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36471 NJX SCLRNG SOL MULTPL VEINS SAME LEG", "code_information": [{"code": "36471", "type": "CPT"}, {"code": "190481", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 428.0, "discounted_cash": 85.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36475 ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN", "code_information": [{"code": "36475", "type": "CPT"}, {"code": "101913", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 5157.0, "discounted_cash": 1031.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36476 ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 2ND VEINS", "code_information": [{"code": "36476", "type": "CPT"}, {"code": "101915", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3219.0, "discounted_cash": 643.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36478 ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN", "code_information": [{"code": "36478", "type": "CPT"}, {"code": "101917", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 4154.0, "discounted_cash": 830.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36479 ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND VEINS", "code_information": [{"code": "36479", "type": "CPT"}, {"code": "101919", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3397.0, "discounted_cash": 679.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36481 PRQ PORTAL VEIN CATHJ ANY METH", "code_information": [{"code": "36481", "type": "CPT"}, {"code": "101921", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4249.0, "discounted_cash": 849.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36482 ENDOVEN THER CHEM ADHES 1ST VEIN", "code_information": [{"code": "36482", "type": "CPT"}, {"code": "195897", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 7167.0, "discounted_cash": 1433.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36510 CATHETERIZATION UMBILICAL VEIN, NEWBORN", "code_information": [{"code": "36510", "type": "CPT"}, {"code": "180339", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1083.0, "discounted_cash": 216.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36555 INSJ NON-TUN CTR CVC UNDER 5 YR", "code_information": [{"code": "36555", "type": "CPT"}, {"code": "101943", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4909.0, "discounted_cash": 981.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36556 INSJ NON-TUN CTR CVC AGE 5 YR/>", "code_information": [{"code": "36556", "type": "CPT"}, {"code": "101945", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3826.0, "discounted_cash": 765.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36557 INSJ TUN CTR CVC W/O SUBQ PORT/PMP UNDER 5 YR", "code_information": [{"code": "36557", "type": "CPT"}, {"code": "101947", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6906.0, "discounted_cash": 1381.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36558 INSJ TUN CTR CVC W/O SUBQ PORT/PMP AGE 5 YR/>", "code_information": [{"code": "36558", "type": "CPT"}, {"code": "101949", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6906.0, "discounted_cash": 1381.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36560 INSJ TUN CTR CTR VAD W/SUBQ PORT UNDER 5 YR", "code_information": [{"code": "36560", "type": "CPT"}, {"code": "101951", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8826.0, "discounted_cash": 1765.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36561 INSJ TUN CTR CTR VAD W/SUBQ PORT AGE 5 YR/>", "code_information": [{"code": "36561", "type": "CPT"}, {"code": "101953", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11391.0, "discounted_cash": 2278.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36568 INSJ PRPH CVC W/O SUBQ PRT/PMP W/O IMGDE < 5 YR", "code_information": [{"code": "36568", "type": "CPT"}, {"code": "200060", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3572.0, "discounted_cash": 714.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36569 INSJ PRPH CVC W/O SUBQ PRT/PMP W/O IMGDE 5 YR/>", "code_information": [{"code": "36569", "type": "CPT"}, {"code": "200064", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3780.0, "discounted_cash": 756.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36573 INSJ PRPH CVC W/O SUBQ PRT/PMP W/ IMGDE 5 YR/>", "code_information": [{"code": "36573", "type": "CPT"}, {"code": "200066", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4065.0, "discounted_cash": 813.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36578 RPLCMT CATH CTR VAD SUBQ PORT/PMP", "code_information": [{"code": "36578", "type": "CPT"}, {"code": "101973", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6906.0, "discounted_cash": 1381.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36580 RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP", "code_information": [{"code": "36580", "type": "CPT"}, {"code": "101975", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3572.0, "discounted_cash": 714.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36581 RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP", "code_information": [{"code": "36581", "type": "CPT"}, {"code": "101977", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6906.0, "discounted_cash": 1381.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36582 RPLCMT COMPL TUN CTR VAD W/SUBQ PORT", "code_information": [{"code": "36582", "type": "CPT"}, {"code": "101979", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8826.0, "discounted_cash": 1765.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36584 RPLCMT COMPL PRPH CVC W/O SUBQ PORT/PMP RS&I", "code_information": [{"code": "36584", "type": "CPT"}, {"code": "101983", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3572.0, "discounted_cash": 714.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36589 RMVL TUN CVC W/O SUBQ PORT/PMP", "code_information": [{"code": "36589", "type": "CPT"}, {"code": "101987", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5420.0, "discounted_cash": 1084.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36590 RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ", "code_information": [{"code": "36590", "type": "CPT"}, {"code": "101989", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2066.0, "discounted_cash": 413.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36591 BLOOD DRAW,IMPLANTED VAD", "code_information": [{"code": "36591", "type": "CPT"}, {"code": "101991", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 31.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36592 BLOOD DRAW,ESTAB PICC/PVC", "code_information": [{"code": "36592", "type": "CPT"}, {"code": "101993", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 234.0, "discounted_cash": 46.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36593 DECLOT VAD/CATH W THROMB AGENT", "code_information": [{"code": "36593", "type": "CPT"}, {"code": "101995", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1654.0, "discounted_cash": 330.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36595 MECH REM OBSTRUCT PERICATH", "code_information": [{"code": "36595", "type": "CPT"}, {"code": "101997", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6516.0, "discounted_cash": 1303.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36597 CVP REPOSITION, W/FLUORO", "code_information": [{"code": "36597", "type": "CPT"}, {"code": "102001", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3780.0, "discounted_cash": 756.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36598 INJ CONTR W/FLUOR EVAL CVAD", "code_information": [{"code": "36598", "type": "CPT"}, {"code": "162862", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 742.0, "discounted_cash": 148.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36598 INJ CONTRAST EXIST CVAD", "code_information": [{"code": "36598", "type": "CPT"}, {"code": "102003", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 742.0, "discounted_cash": 148.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36600 ARTERIAL PUNCTURE - DRAW BLOOD", "code_information": [{"code": "36600", "type": "CPT"}, {"code": "102005", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 64.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36600 ARTERIAL PUNCTURE - DRAW BLOOD", "code_information": [{"code": "36600", "type": "CPT"}, {"code": "196606", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 64.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36620 ARTERIAL CATHETERIZATION; PERC", "code_information": [{"code": "36620", "type": "CPT"}, {"code": "194490", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1513.0, "discounted_cash": 302.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36620 ARTERIAL CATHETERIZATION; PERC", "code_information": [{"code": "36620", "type": "CPT"}, {"code": "302463", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1513.0, "discounted_cash": 302.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36625 CUTDOWN ARTERIAL CATH MONITOR", "code_information": [{"code": "36625", "type": "CPT"}, {"code": "102007", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 62.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36660 CATHETERIZATION UMBILICAL ARTERY, NEWBORN", "code_information": [{"code": "36660", "type": "CPT"}, {"code": "180341", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1083.0, "discounted_cash": 216.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36680 INTRAOSSEOUS INFUSION", "code_information": [{"code": "36680", "type": "CPT"}, {"code": "102009", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2153.0, "discounted_cash": 430.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36901 INTRO CATH DIALYSIS CIRCUT DX ANGRPH FL S&I", "code_information": [{"code": "36901", "type": "CPT"}, {"code": "190459", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4806.0, "discounted_cash": 961.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36902 INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP", "code_information": [{"code": "36902", "type": "CPT"}, {"code": "190501", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19462.0, "discounted_cash": 3892.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36903 INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT", "code_information": [{"code": "36903", "type": "CPT"}, {"code": "190503", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39330.0, "discounted_cash": 7866.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36904 PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH", "code_information": [{"code": "36904", "type": "CPT"}, {"code": "190485", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19462.0, "discounted_cash": 3892.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36905 PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP", "code_information": [{"code": "36905", "type": "CPT"}, {"code": "190487", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 39330.0, "discounted_cash": 7866.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36906 PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT", "code_information": [{"code": "36906", "type": "CPT"}, {"code": "190489", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 47756.0, "discounted_cash": 9551.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36907 TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I", "code_information": [{"code": "36907", "type": "CPT"}, {"code": "190505", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19104.0, "discounted_cash": 3820.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36908 TCAT PLMT IV STENT CTR DIALYSIS SEG W/IMG S&I", "code_information": [{"code": "36908", "type": "CPT"}, {"code": "190507", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19104.0, "discounted_cash": 3820.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 36909 DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I", "code_information": [{"code": "36909", "type": "CPT"}, {"code": "190509", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19104.0, "discounted_cash": 3820.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37182 TIPS INSERTION I/P ONLY", "code_information": [{"code": "37182", "type": "CPT"}, {"code": "102013", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20328.0, "discounted_cash": 4065.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37183 TIPS REVISION", "code_information": [{"code": "37183", "type": "CPT"}, {"code": "102015", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20328.0, "discounted_cash": 4065.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37184 PRIM PRQ TRLUML MCHNL THRMBC 1ST VSL", "code_information": [{"code": "37184", "type": "CPT"}, {"code": "102017", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6400.0, "discounted_cash": 1280.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37185 PRIM PRQ TRLUML MCHNL THRMBC SBSQ VSL", "code_information": [{"code": "37185", "type": "CPT"}, {"code": "102019", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4875.0, "discounted_cash": 975.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37186 SEC PRQ TRLUML THRMBC", "code_information": [{"code": "37186", "type": "CPT"}, {"code": "102021", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6400.0, "discounted_cash": 1280.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37187 PERC MECH TROMBECTOMY (DAY 1)", "code_information": [{"code": "37187", "type": "CPT"}, {"code": "162870", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6400.0, "discounted_cash": 1280.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37187 THROMBEC VENOUS MECH DAY 1", "code_information": [{"code": "37187", "type": "CPT"}, {"code": "102023", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7180.0, "discounted_cash": 1436.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37188 THROMBEC VENOUS MECH REPEAT", "code_information": [{"code": "37188", "type": "CPT"}, {"code": "102025", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6400.0, "discounted_cash": 1280.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37191 INSERT VENA CAVA FILTER", "code_information": [{"code": "37191", "type": "CPT"}, {"code": "152922", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 14885.0, "discounted_cash": 2977.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37192 REPOSITION VENA CAVA FILTER", "code_information": [{"code": "37192", "type": "CPT"}, {"code": "152924", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15088.0, "discounted_cash": 3017.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37193 REMOVAL VENA CAVA FILTER", "code_information": [{"code": "37193", "type": "CPT"}, {"code": "152926", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 15088.0, "discounted_cash": 3017.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37195 THROMBOLYTIC THERAPY STROKE IV INFUSION", "code_information": [{"code": "37195", "type": "CPT"}, {"code": "185304", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1326.0, "discounted_cash": 265.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37197 TRANSCATH RETRIEVE FB W/RSI & GUIDANCE", "code_information": [{"code": "37197", "type": "CPT"}, {"code": "273793", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6368.0, "discounted_cash": 1273.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37200 TRANSCATH BIOPSY", "code_information": [{"code": "37200", "type": "CPT"}, {"code": "102027", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2058.0, "discounted_cash": 411.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37211 TRANSCATH ART INF THROMBOL,INITIAL", "code_information": [{"code": "37211", "type": "CPT"}, {"code": "273785", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4258.0, "discounted_cash": 851.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37212 TRANSCATH VENOUS INF THROMBOL,INITIAL", "code_information": [{"code": "37212", "type": "CPT"}, {"code": "273787", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4258.0, "discounted_cash": 851.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37213 TRANSCATH ART/VEN INF THROMBOL,SUBSQ", "code_information": [{"code": "37213", "type": "CPT"}, {"code": "273789", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3223.0, "discounted_cash": 644.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37214 TRANSCATH ART/VEN INF THROMBOL,SUBSQ,RMVL/CLOSE", "code_information": [{"code": "37214", "type": "CPT"}, {"code": "273791", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3223.0, "discounted_cash": 644.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37215 TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ", "code_information": [{"code": "37215", "type": "CPT"}, {"code": "102045", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 34768.0, "discounted_cash": 6953.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37216 TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ", "code_information": [{"code": "37216", "type": "CPT"}, {"code": "102047", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 38998.0, "discounted_cash": 7799.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37218 TCAT STENT PLACEMT ANTE CAROTID", "code_information": [{"code": "37218", "type": "CPT"}, {"code": "181438", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 38547.0, "discounted_cash": 7709.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37220 ILIAC VESSEL, INITIAL PTA", "code_information": [{"code": "37220", "type": "CPT"}, {"code": "102049", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16933.0, "discounted_cash": 3386.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37221 ILIAC INITIAL VESSEL, STENT", "code_information": [{"code": "37221", "type": "CPT"}, {"code": "102051", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 34254.0, "discounted_cash": 6850.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37222 ILIAC VESSEL, ADDITIONAL PTA", "code_information": [{"code": "37222", "type": "CPT"}, {"code": "102053", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17137.0, "discounted_cash": 3427.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37223 ILIAC VESSEL, ADDITIONAL VESSEL", "code_information": [{"code": "37223", "type": "CPT"}, {"code": "102055", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 33846.0, "discounted_cash": 6769.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37224 FEMPOP ARTERY(S), UNILATERAL", "code_information": [{"code": "37224", "type": "CPT"}, {"code": "102057", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17137.0, "discounted_cash": 3427.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37225 FEMPOP ARTERY(S), UNILATERAL", "code_information": [{"code": "37225", "type": "CPT"}, {"code": "102059", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40000.0, "discounted_cash": 8000.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37226 STENT FEM/POP W/WO PTA", "code_information": [{"code": "37226", "type": "CPT"}, {"code": "102061", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40000.0, "discounted_cash": 8000.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37227 STENT & ATH W/WO PTA FEM/POP", "code_information": [{"code": "37227", "type": "CPT"}, {"code": "102063", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 62972.0, "discounted_cash": 12594.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37228 TIB/PER., UNILATERAL, INITIAL", "code_information": [{"code": "37228", "type": "CPT"}, {"code": "102065", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17137.0, "discounted_cash": 3427.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37229 TIB/PER., UNILATERAL, INITIAL", "code_information": [{"code": "37229", "type": "CPT"}, {"code": "102067", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40000.0, "discounted_cash": 8000.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37230 TIB/PER., UNILATERAL, INITIAL", "code_information": [{"code": "37230", "type": "CPT"}, {"code": "102069", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40000.0, "discounted_cash": 8000.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37231 TIB/PER., UNILATERAL, INITIAL", "code_information": [{"code": "37231", "type": "CPT"}, {"code": "102071", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 62972.0, "discounted_cash": 12594.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37232 TIB/PER., UNILATERAL, EACH ADD", "code_information": [{"code": "37232", "type": "CPT"}, {"code": "102073", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17137.0, "discounted_cash": 3427.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37233 TIB/PER., UNILATERAL, EA ADDIT", "code_information": [{"code": "37233", "type": "CPT"}, {"code": "102075", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 40000.0, "discounted_cash": 8000.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37234 TIB/PER., UNILATERAL, EACH ADD", "code_information": [{"code": "37234", "type": "CPT"}, {"code": "102077", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 34254.0, "discounted_cash": 6850.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37235 TIB/PER., UNILATERAL, EA ADDIT", "code_information": [{"code": "37235", "type": "CPT"}, {"code": "102079", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 34270.0, "discounted_cash": 6854.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37236 OPN/PERQ TRNSCTH STENT PLCMNT INIT ART", "code_information": [{"code": "37236", "type": "CPT"}, {"code": "304595", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17283.0, "discounted_cash": 3456.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37237 OPN/PERQ TRNSCTH STENT PLCMNT EA ADDL ART", "code_information": [{"code": "37237", "type": "CPT"}, {"code": "304599", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 20971.0, "discounted_cash": 4194.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37238 OPN/PERQ TRNSCTH STENT PLCMNT INIT VEIN", "code_information": [{"code": "37238", "type": "CPT"}, {"code": "304597", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16018.0, "discounted_cash": 3203.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37239 OPN/PERQ TRNSCTH STENT PLCMNT EA ADDL VEIN", "code_information": [{"code": "37239", "type": "CPT"}, {"code": "304601", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11426.0, "discounted_cash": 2285.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37241 VASC EMBOLIZE/OCCLUDE VENOUS", "code_information": [{"code": "37241", "type": "CPT"}, {"code": "304587", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11828.0, "discounted_cash": 2365.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37242 VASC EMBOLIZE/OCCLUDE ARTERY", "code_information": [{"code": "37242", "type": "CPT"}, {"code": "304589", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11828.0, "discounted_cash": 2365.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37243 VASC EMBOLIZ/OCCLUDE TUM/ORGAN/INFARCT", "code_information": [{"code": "37243", "type": "CPT"}, {"code": "304591", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13267.0, "discounted_cash": 2653.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37244 VASC EMBOLIZE/OCCLUDE ART/VEN BLEED", "code_information": [{"code": "37244", "type": "CPT"}, {"code": "304593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13267.0, "discounted_cash": 2653.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37246 TRLML BALO ANGIOP OPN/PRQ IMG S&I 1ST ART", "code_information": [{"code": "37246", "type": "CPT"}, {"code": "190463", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19686.0, "discounted_cash": 3937.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37247 TRLML BALO ANGIOP OPN/PRQ IMG S&I EA ADDL ART", "code_information": [{"code": "37247", "type": "CPT"}, {"code": "190467", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3791.0, "discounted_cash": 758.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37248 TRLML BALO ANGIOP OPN/PRQ IMG S&I 1ST VEIN", "code_information": [{"code": "37248", "type": "CPT"}, {"code": "190465", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 19686.0, "discounted_cash": 3937.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37249 TRLML BALO ANGIOP OPN/PRQ IMG S&I ADDL VEIN", "code_information": [{"code": "37249", "type": "CPT"}, {"code": "190461", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3746.0, "discounted_cash": 749.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37252 INTRVASC US NONCORONARY 1ST", "code_information": [{"code": "37252", "type": "CPT"}, {"code": "181454", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6990.0, "discounted_cash": 1398.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37253 INTRVASC US NONCORONARY ADDL", "code_information": [{"code": "37253", "type": "CPT"}, {"code": "181456", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7074.0, "discounted_cash": 1414.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37609 LIG/BX TEMPORAL ART", "code_information": [{"code": "37609", "type": "CPT"}, {"code": "102087", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2557.0, "discounted_cash": 511.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37766 STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS", "code_information": [{"code": "37766", "type": "CPT"}, {"code": "102093", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 4648.0, "discounted_cash": 929.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 37799 UNLIS PX VASC SURG", "code_information": [{"code": "37799", "type": "CPT"}, {"code": "102095", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5899.0, "discounted_cash": 1179.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 38220 DX BONE MARROW DX; ASPIRATION(S)", "code_information": [{"code": "38220", "type": "CPT"}, {"code": "301889", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1359.0, "discounted_cash": 271.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 38221 DX BONE MARROW DX; BIOPSY(IES)", "code_information": [{"code": "38221", "type": "CPT"}, {"code": "102099", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1442.0, "discounted_cash": 288.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 38222 DX BONE MARROW DX; BIOPSY(IES) AND ASPIRATION(S)", "code_information": [{"code": "38222", "type": "CPT"}, {"code": "182878", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2707.0, "discounted_cash": 541.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 38505 BX/EXC LYMPH NODE NDL SUPFC", "code_information": [{"code": "38505", "type": "CPT"}, {"code": "102105", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2469.0, "discounted_cash": 493.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 38792 INJECTION FOR IDENTIFICATION OF SENTINEL NODE", "code_information": [{"code": "38792", "type": "CPT"}, {"code": "102107", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 810.0, "discounted_cash": 162.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 3D RENDERING (MRI)", "code_information": [{"code": "76376", "type": "CPT"}, {"code": "216943", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 1276.0, "discounted_cash": 255.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40650 RPR LIP FULL THKNS VERMILION ONLY", "code_information": [{"code": "40650", "type": "CPT"}, {"code": "102123", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3462.0, "discounted_cash": 692.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40652 RPR LIP FULL THKNS UP HALF VER H8", "code_information": [{"code": "40652", "type": "CPT"}, {"code": "102125", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9771.0, "discounted_cash": 1954.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40654 RPR LIP FULL THKNS > ONE-HALF VER H8/CPLX", "code_information": [{"code": "40654", "type": "CPT"}, {"code": "102127", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3563.0, "discounted_cash": 712.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40799 UNLIS PX LIPS", "code_information": [{"code": "40799", "type": "CPT"}, {"code": "102129", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2425.0, "discounted_cash": 485.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40800 DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL", "code_information": [{"code": "40800", "type": "CPT"}, {"code": "102131", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 954.0, "discounted_cash": 190.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40801 DRG ABSC CST HMTMA VESTIBULE MOUTH COMP", "code_information": [{"code": "40801", "type": "CPT"}, {"code": "102133", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3524.0, "discounted_cash": 704.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40804 RMVL EMBEDDED FB VESTIBULE MOUTH SMPL", "code_information": [{"code": "40804", "type": "CPT"}, {"code": "102135", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1063.0, "discounted_cash": 212.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40805 RMVL EMBEDDED FB VESTIBULE MOUTH COMP", "code_information": [{"code": "40805", "type": "CPT"}, {"code": "102137", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3459.0, "discounted_cash": 691.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40808 BX VESTIBULE MOUTH", "code_information": [{"code": "40808", "type": "CPT"}, {"code": "102139", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 606.0, "discounted_cash": 121.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40812 EXC LES MUCOSA&SBMCSL VESTIBULE SMPL RPR", "code_information": [{"code": "40812", "type": "CPT"}, {"code": "102143", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2804.0, "discounted_cash": 560.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40830 CLSR LAC VESTIBULE MOUTH 2.5 CM/<", "code_information": [{"code": "40830", "type": "CPT"}, {"code": "102147", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1199.0, "discounted_cash": 239.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 40831 CLSR LAC VESTIBULE MOUTH > 2.5 CM/CPLX", "code_information": [{"code": "40831", "type": "CPT"}, {"code": "102149", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3462.0, "discounted_cash": 692.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41000 INTRAORAL I&D TONGUE/FLOOR LNGL", "code_information": [{"code": "41000", "type": "CPT"}, {"code": "102151", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7627.0, "discounted_cash": 1525.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41005 INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC", "code_information": [{"code": "41005", "type": "CPT"}, {"code": "102153", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1156.0, "discounted_cash": 231.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41007 INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE", "code_information": [{"code": "41007", "type": "CPT"}, {"code": "102155", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 10283.0, "discounted_cash": 2056.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41008 INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE", "code_information": [{"code": "41008", "type": "CPT"}, {"code": "227052", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8982.0, "discounted_cash": 1796.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41009 INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC", "code_information": [{"code": "41009", "type": "CPT"}, {"code": "186151", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1110.0, "discounted_cash": 222.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41010 INC LNGL FRENUM FREXOMY", "code_information": [{"code": "41010", "type": "CPT"}, {"code": "102157", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1724.0, "discounted_cash": 344.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41015 XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBLNGL", "code_information": [{"code": "41015", "type": "CPT"}, {"code": "102159", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1154.0, "discounted_cash": 230.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41016 DRAINAGE OF MOUTH LESION", "code_information": [{"code": "41016", "type": "CPT"}, {"code": "177382", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9539.0, "discounted_cash": 1907.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41017 XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB", "code_information": [{"code": "41017", "type": "CPT"}, {"code": "176405", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8224.0, "discounted_cash": 1644.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41100 BX VESTIBULE MOUTH", "code_information": [{"code": "41100", "type": "CPT"}, {"code": "102161", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 620.0, "discounted_cash": 124.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41108 BIOPSY OF FLOOR OF MOUTH", "code_information": [{"code": "41108", "type": "CPT"}, {"code": "229599", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2217.0, "discounted_cash": 443.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41112 EXC LES TONGUE W/CLSR; ANT TWO THIRD", "code_information": [{"code": "41112", "type": "CPT"}, {"code": "175876", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3485.0, "discounted_cash": 697.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41114 EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP", "code_information": [{"code": "41114", "type": "CPT"}, {"code": "188209", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3850.0, "discounted_cash": 770.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41250 RPR LAC 2.5 CM/< FLOOR MOUTH&/ANT 2-3RD TONGUE", "code_information": [{"code": "41250", "type": "CPT"}, {"code": "102167", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1301.0, "discounted_cash": 260.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41251 RPR LAC 2.5 CM/< PST ONE-3RD TONGUE", "code_information": [{"code": "41251", "type": "CPT"}, {"code": "102169", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4035.0, "discounted_cash": 807.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41252 RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX", "code_information": [{"code": "41252", "type": "CPT"}, {"code": "102171", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2073.0, "discounted_cash": 414.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41599 UNLIS PX TONGUE FLOOR MOUTH", "code_information": [{"code": "41599", "type": "CPT"}, {"code": "102173", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2088.0, "discounted_cash": 417.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41800 DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS", "code_information": [{"code": "41800", "type": "CPT"}, {"code": "102175", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1360.0, "discounted_cash": 272.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41805 RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS", "code_information": [{"code": "41805", "type": "CPT"}, {"code": "102177", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 10873.0, "discounted_cash": 2174.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41826 EXC LES/TUM XCP LISTED ABOVE DENTALVLR SMPL RPR", "code_information": [{"code": "41826", "type": "CPT"}, {"code": "102179", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9742.0, "discounted_cash": 1948.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 41899 UNLIS PX DENTOALVEOLAR STRUXS", "code_information": [{"code": "41899", "type": "CPT"}, {"code": "102181", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4690.0, "discounted_cash": 938.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42000 DRG ABSC PALATE UVULA", "code_information": [{"code": "42000", "type": "CPT"}, {"code": "102183", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1226.0, "discounted_cash": 245.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42100 BX PALATE UVULA", "code_information": [{"code": "42100", "type": "CPT"}, {"code": "102185", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1893.0, "discounted_cash": 378.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42180 RPR LAC PALATE UP 2 CM", "code_information": [{"code": "42180", "type": "CPT"}, {"code": "226468", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2652.0, "discounted_cash": 530.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42299 UNLIS PX PALATE UVULA", "code_information": [{"code": "42299", "type": "CPT"}, {"code": "102191", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 920.0, "discounted_cash": 184.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42310 DRG ABSC SUBMAX/SUBLNGL INTRAORAL", "code_information": [{"code": "42310", "type": "CPT"}, {"code": "102193", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1199.0, "discounted_cash": 239.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42400 BX SALIVARY GLND NDL", "code_information": [{"code": "42400", "type": "CPT"}, {"code": "102197", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2469.0, "discounted_cash": 493.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42550 NJX SIALOGRAPY", "code_information": [{"code": "42550", "type": "CPT"}, {"code": "102199", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 523.0, "discounted_cash": 104.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42700 I&D ABSC PRITONSILLAR", "code_information": [{"code": "42700", "type": "CPT"}, {"code": "102201", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1145.0, "discounted_cash": 229.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42800 BX OROPHARYNX", "code_information": [{"code": "42800", "type": "CPT"}, {"code": "102203", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2131.0, "discounted_cash": 426.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42809 RMVL FB PHARYNX", "code_information": [{"code": "42809", "type": "CPT"}, {"code": "102205", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 545.0, "discounted_cash": 109.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42960 CTRL OROPHARYNGEAL HEMRRG 1/2 SMPL", "code_information": [{"code": "42960", "type": "CPT"}, {"code": "102207", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1179.0, "discounted_cash": 235.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42970 CTRL NASPHRYNGL HEMRRG 1/2 SMPL W/PST NSL PACKS", "code_information": [{"code": "42970", "type": "CPT"}, {"code": "102209", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 552.0, "discounted_cash": 110.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 42999 UNLIS PX PHARYNX ADENOIDS/TONSILS", "code_information": [{"code": "42999", "type": "CPT"}, {"code": "102211", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 3545.0, "discounted_cash": 709.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43180 ESOPHAGOSCOPY RIGID TRNSL W CRICOPHNYGL MYOTMY", "code_information": [{"code": "43180", "type": "CPT"}, {"code": "298082", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 26250.0, "discounted_cash": 5250.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43191 ESOPHAGOSCOPY RIGID TRNSO DX", "code_information": [{"code": "43191", "type": "CPT"}, {"code": "256500", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5217.0, "discounted_cash": 1043.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43197 ESOPHAGOSCOPY FLEX TRANSNASAL DX", "code_information": [{"code": "43197", "type": "CPT"}, {"code": "252263", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 991.0, "discounted_cash": 198.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43200 ESPHGSC FLXORL DX COLL SPEC BR/WA", "code_information": [{"code": "43200", "type": "CPT"}, {"code": "102213", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3717.0, "discounted_cash": 743.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43201 ESPHGSC FLXORL DRCTD SBMCSL NJX ANY SBST", "code_information": [{"code": "43201", "type": "CPT"}, {"code": "102215", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 2043.0, "discounted_cash": 408.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43202 ESPHGSC FLXORL W/BX 1/MLT", "code_information": [{"code": "43202", "type": "CPT"}, {"code": "102217", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3704.0, "discounted_cash": 740.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43205 ESPHGSC FLXORL W/BAND LIG ESOPHGL VARC", "code_information": [{"code": "43205", "type": "CPT"}, {"code": "102221", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5741.0, "discounted_cash": 1148.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43210 ESPHGSC FLXORL ESOPHAGOGASTRC FNDOPLSTY", "code_information": [{"code": "43210", "type": "CPT"}, {"code": "185948", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 13924.0, "discounted_cash": 2784.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43212 ESPHGSC FLXORL STENT PLCMNT", "code_information": [{"code": "43212", "type": "CPT"}, {"code": "180476", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5251.0, "discounted_cash": 1050.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43214 ESPHGSC FLXORL DILATE W/BALLOON 30MM>", "code_information": [{"code": "43214", "type": "CPT"}, {"code": "304617", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5295.0, "discounted_cash": 1059.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43215 ESPHGSC FLXORL W/RMVL FB(S)", "code_information": [{"code": "43215", "type": "CPT"}, {"code": "102223", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4369.0, "discounted_cash": 873.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43220 ESPHGSC RGD/FLX W/BALO DILAT < 30 MM DIAM", "code_information": [{"code": "43220", "type": "CPT"}, {"code": "102231", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4257.0, "discounted_cash": 851.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43226 ESPHGSC FLXORL DIL W/DIL OVER GDEWR", "code_information": [{"code": "43226", "type": "CPT"}, {"code": "180480", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4591.0, "discounted_cash": 918.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43229 ESPHGSC FLXORL W/ABLATE TUM/POLYP/LES", "code_information": [{"code": "43229", "type": "CPT"}, {"code": "302308", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 6951.0, "discounted_cash": 1390.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43231 ESPHGSC RGD/FLX W/NDSC US XM", "code_information": [{"code": "43231", "type": "CPT"}, {"code": "102239", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4071.0, "discounted_cash": 814.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43233 EGD FLXORL DILATE W/BALLOON 30MM>", "code_information": [{"code": "43233", "type": "CPT"}, {"code": "304619", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 19425.0, "discounted_cash": 3885.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43235 EGD FLXORL SCOPE FOR DIAGNOSIS", "code_information": [{"code": "43235", "type": "CPT"}, {"code": "102243", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4071.0, "discounted_cash": 814.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43236 EGD FLXORL SCOPE, SUBMUCSL INJ,ANY SUBST", "code_information": [{"code": "43236", "type": "CPT"}, {"code": "102245", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 2986.0, "discounted_cash": 597.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43237 EGD FLXORL EUS LMTD TO E/S/D/AS", "code_information": [{"code": "43237", "type": "CPT"}, {"code": "102247", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 9280.0, "discounted_cash": 1856.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43238 EGD FLXORL TRNS US GUIDE FNA/BX ESOPH", "code_information": [{"code": "43238", "type": "CPT"}, {"code": "102249", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 9280.0, "discounted_cash": 1856.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43239 EGD FLXORL SCOPE FOR BIOPSY(S)", "code_information": [{"code": "43239", "type": "CPT"}, {"code": "102251", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5353.0, "discounted_cash": 1070.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43240 EGD FLXORL TRANSMURAL DRG PSEUDOCST", "code_information": [{"code": "43240", "type": "CPT"}, {"code": "102253", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 9530.0, "discounted_cash": 1906.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43241 EGD FLXORL INTRALMNL TUBE/CATH PLMT", "code_information": [{"code": "43241", "type": "CPT"}, {"code": "102255", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3537.0, "discounted_cash": 707.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43242 EGD FLXORL W/US GDE FNA BX", "code_information": [{"code": "43242", "type": "CPT"}, {"code": "275425", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5487.0, "discounted_cash": 1097.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43243 EGD FLXORL INJ SCLEROSIS ESPHGL GSTR VARC", "code_information": [{"code": "43243", "type": "CPT"}, {"code": "102259", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 6228.0, "discounted_cash": 1245.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43244 EGD FLXORL W/LIGAT.ESOPH/GAST VARICES", "code_information": [{"code": "43244", "type": "CPT"}, {"code": "163050", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 2986.0, "discounted_cash": 597.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43245 EGD FLXORL DILAT GSTR/DUO OUTLET OBSTRCJ", "code_information": [{"code": "43245", "type": "CPT"}, {"code": "102261", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5066.0, "discounted_cash": 1013.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43246 EGD FLXORL DIRED PLMT PRQ GASTRSTMY TUBE", "code_information": [{"code": "43246", "type": "CPT"}, {"code": "102263", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 7278.0, "discounted_cash": 1455.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43246 FLXORL BDSIDE PLMT PERC GSTRSTMY TUBE", "code_information": [{"code": "43246", "type": "CPT"}, {"code": "202749", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 7278.0, "discounted_cash": 1455.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43247 EGD FLXORL SCOPE W/RMVL FB(S)", "code_information": [{"code": "43247", "type": "CPT"}, {"code": "102265", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5167.0, "discounted_cash": 1033.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43248 EGD FLXORL DILAT ESOPH > GDWIRE", "code_information": [{"code": "43248", "type": "CPT"}, {"code": "102267", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 2986.0, "discounted_cash": 597.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43249 EGD FLXORL BALO DILAT ESOPH < 30 MM DIAM", "code_information": [{"code": "43249", "type": "CPT"}, {"code": "102269", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5143.0, "discounted_cash": 1028.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43250 EGD FLXORL RMVL LES HOT BX FRCEPS", "code_information": [{"code": "43250", "type": "CPT"}, {"code": "102271", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5093.0, "discounted_cash": 1018.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43251 EGD FLXORL RMVL TUM POLYP/OTH LES SNARE TQ", "code_information": [{"code": "43251", "type": "CPT"}, {"code": "102273", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4979.0, "discounted_cash": 995.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43253 EGD FLXORL US TRANSMURAL INJXN/MARK", "code_information": [{"code": "43253", "type": "CPT"}, {"code": "176153", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4139.0, "discounted_cash": 827.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43254 EGD FLXORL ENDO MUCOSAL RESECTION", "code_information": [{"code": "43254", "type": "CPT"}, {"code": "175874", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5467.0, "discounted_cash": 1093.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43255 EGD FLXORL CTRL BLEED ANY METHD", "code_information": [{"code": "43255", "type": "CPT"}, {"code": "102275", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 6796.0, "discounted_cash": 1359.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43259 EGD FLXORL SCOPE W US EXM E/S/DUO/SAS", "code_information": [{"code": "43259", "type": "CPT"}, {"code": "102281", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 8783.0, "discounted_cash": 1756.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43260 ERCP DX COLLJ SPEC BR/WA SPX", "code_information": [{"code": "43260", "type": "CPT"}, {"code": "102283", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5921.0, "discounted_cash": 1184.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43261 ERCP W/BX 1/MLT", "code_information": [{"code": "43261", "type": "CPT"}, {"code": "102285", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5191.0, "discounted_cash": 1038.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43262 ERCP W/SPHNCTROTOMY/PAPILLOTOMY", "code_information": [{"code": "43262", "type": "CPT"}, {"code": "102287", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 9142.0, "discounted_cash": 1828.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43264 ERCP W/RMVL CALCULI BILIARY&/PNCRTC DUXS", "code_information": [{"code": "43264", "type": "CPT"}, {"code": "102291", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 7303.0, "discounted_cash": 1460.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43265 ERCP W/DSTRJ LITHOTRP CALCULI ANY METH", "code_information": [{"code": "43265", "type": "CPT"}, {"code": "102293", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 6644.0, "discounted_cash": 1328.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43266 EGD FLXORL NDSC STENT PLMT W/PREDILAT", "code_information": [{"code": "43266", "type": "CPT"}, {"code": "304603", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 8189.0, "discounted_cash": 1637.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43270 EGD FLXORL ABLATE TUMOR/POLYPS/LES", "code_information": [{"code": "43270", "type": "CPT"}, {"code": "304605", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 6828.0, "discounted_cash": 1365.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43273 ENDOSCOPIC PANCREATOSCOPY", "code_information": [{"code": "43273", "type": "CPT"}, {"code": "301029", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": 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"outpatient", "billing_class": "facility"}]}, {"description": "HC 43277 ERCP TRNSENDO BAL DIL BIL/PAN DUCT,EACH", "code_information": [{"code": "43277", "type": "CPT"}, {"code": "304613", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5534.0, "discounted_cash": 1106.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43278 ERCP LES/TUM/POLYP ABLATE", "code_information": [{"code": "43278", "type": "CPT"}, {"code": "304615", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5893.0, "discounted_cash": 1178.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43450 OPENING OF ESOPHAGUS", "code_information": [{"code": "43450", "type": "CPT"}, {"code": "102305", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3433.0, "discounted_cash": 686.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43497 TRANSORAL LOWER ESOPHAGEAL MYOTOMY", "code_information": [{"code": "43497", "type": "CPT"}, {"code": "296367", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 26250.0, "discounted_cash": 5250.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43499 FLX CIPROPHARYNGEAL MYOTOMY (ZENKER'S)", "code_information": [{"code": "43499", "type": "CPT"}, {"code": "102557", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 6555.0, "discounted_cash": 1311.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43499 UNLIS PX ESOPH", "code_information": [{"code": "43499", "type": "CPT"}, {"code": "102309", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 6035.0, "discounted_cash": 1207.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43752 NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDN", "code_information": [{"code": "43752", "type": "CPT"}, {"code": "102313", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1165.0, "discounted_cash": 233.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43752 NG TUBE PLM'T REQ PHYS & FLUORO GUIDE", "code_information": [{"code": "43752", "type": "CPT"}, {"code": "163082", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1165.0, "discounted_cash": 233.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43753 GASTRIC LAVAGE/ASPIRATION", "code_information": [{"code": "43753", "type": "CPT"}, {"code": "102315", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1095.0, "discounted_cash": 219.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43761 REPOSITION GASTRIC FEEDING TUBE THRU DUODENUM", "code_information": [{"code": "43761", "type": "CPT"}, {"code": "102319", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3171.0, "discounted_cash": 634.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43762 PERQ REPLC GTUBE,W/O IMG GDE; W/O REVJN TRACT", "code_information": [{"code": "43762", "type": "CPT"}, {"code": "200078", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 67.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 43999 UNLIS PX STOMACH", "code_information": [{"code": "43999", "type": "CPT"}, {"code": "102321", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3504.0, "discounted_cash": 700.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44360 SM BOW ENTEROSCOPY-DIAGNOSTIC", "code_information": [{"code": "44360", "type": "CPT"}, {"code": "102323", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4845.0, "discounted_cash": 969.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44361 SM BOW ENTEROSCOPY W/BIOPSY", "code_information": [{"code": "44361", "type": "CPT"}, {"code": "102325", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4897.0, "discounted_cash": 979.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44363 SM BOW ENTEROSCOPY W/RMVL FB(S)", "code_information": [{"code": "44363", "type": "CPT"}, {"code": "102327", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4563.0, "discounted_cash": 912.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44364 SM BOW ENTEROSCOPY W/REM POLYP", "code_information": [{"code": "44364", "type": "CPT"}, {"code": "102329", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5284.0, "discounted_cash": 1056.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44366 SM BOW ENTEROSCOPY W/CNTRL BLEED", "code_information": [{"code": "44366", "type": "CPT"}, {"code": "102333", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5727.0, "discounted_cash": 1145.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44369 SM BOW ENTEROSCOPY W/ABLATION", "code_information": [{"code": "44369", "type": "CPT"}, {"code": "102335", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5203.0, "discounted_cash": 1040.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44370 SM BOW ENTEROSCOPY W/STENT PLA", "code_information": [{"code": "44370", "type": "CPT"}, {"code": "102337", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4718.0, "discounted_cash": 943.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44372 SM BOW ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE", "code_information": [{"code": "44372", "type": "CPT"}, {"code": "181463", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5019.0, "discounted_cash": 1003.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44373 SM BOW ENTEROSCOPY W/PEG CONV", "code_information": [{"code": "44373", "type": "CPT"}, {"code": "102339", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5364.0, "discounted_cash": 1072.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44376 ENTEROSCOPY> 2ND PRTN W/ILE-CO", "code_information": [{"code": "44376", "type": "CPT"}, {"code": "102341", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4855.0, "discounted_cash": 971.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44377 ENTEROSCOPY> 2ND PRTN W/ILE W/", "code_information": [{"code": "44377", "type": "CPT"}, {"code": "102343", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5414.0, "discounted_cash": 1082.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44378 ENTEROSCOPY> 2ND PRTN ILE CTRL", "code_information": [{"code": "44378", "type": "CPT"}, {"code": "102345", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 6133.0, "discounted_cash": 1226.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44380 ILEOSCOPY,STOMA,DIAGNOSTIC", "code_information": [{"code": "44380", "type": "CPT"}, {"code": "102349", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4544.0, "discounted_cash": 908.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44381 ILEOSCOPY,STOMA,BALLOON DILATION", "code_information": [{"code": "44381", "type": "CPT"}, {"code": "180304", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4544.0, "discounted_cash": 908.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44382 ILEOSCOPY,STOMA, W BIOPSY(S)", "code_information": [{"code": "44382", "type": "CPT"}, {"code": "180306", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4544.0, "discounted_cash": 908.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44385 ENDOSCOPY OF BOWEL POUCH", "code_information": [{"code": "44385", "type": "CPT"}, {"code": "227746", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3494.0, "discounted_cash": 698.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44386 ENDOSCOPY BOWEL POUCH W/BX", "code_information": [{"code": "44386", "type": "CPT"}, {"code": "185724", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4954.0, "discounted_cash": 990.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44388 COLONOSCOPY,STOMA DIAGNOSTIC", "code_information": [{"code": "44388", "type": "CPT"}, {"code": "102351", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4914.0, "discounted_cash": 982.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44389 COLONOSCOPY,STOMA W/BX", "code_information": [{"code": "44389", "type": "CPT"}, {"code": "102353", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4094.0, "discounted_cash": 818.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44390 COLONOSCOPY,STOMA W/ RMVL FB(S)", "code_information": [{"code": "44390", "type": "CPT"}, {"code": "179937", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4176.0, "discounted_cash": 835.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44391 COLONOSCOPY,STOMA W/CTRL BLEED", "code_information": [{"code": "44391", "type": "CPT"}, {"code": "102357", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 2781.0, "discounted_cash": 556.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44394 COLON/STOMA W/POLYP REMOV SNAR", "code_information": [{"code": "44394", "type": "CPT"}, {"code": "102363", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5649.0, "discounted_cash": 1129.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44401 COLONOSCOPY,STOMA W/ABL LASER", "code_information": [{"code": "44401", "type": "CPT"}, {"code": "102361", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3397.0, "discounted_cash": 679.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44403 COLONOSCOPY, STOMA W/ RESCJ", "code_information": [{"code": "44403", "type": "CPT"}, {"code": "199889", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3958.0, "discounted_cash": 791.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44404 COLONOSCOPY STOMA W/SUBMUCOSAL INJCTN", "code_information": [{"code": "44404", "type": "CPT"}, {"code": "177076", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5775.0, "discounted_cash": 1155.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44405 COLSC THROUGH STOMA W/BALLOON DILATION", "code_information": [{"code": "44405", "type": "CPT"}, {"code": "217268", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4914.0, "discounted_cash": 982.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44500 INTRO GASTROINTESTINAL TUBE SPX", "code_information": [{"code": "44500", "type": "CPT"}, {"code": "176271", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2518.0, "discounted_cash": 503.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 44799 UNLISTED PROC, SMALL INTESTINE", "code_information": [{"code": "44799", "type": "CPT"}, {"code": "102367", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 6483.0, "discounted_cash": 1296.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 45005 I&D SUBMUCOSSAL ABSCESS,RECTUM", "code_information": [{"code": "45005", "type": "CPT"}, {"code": "102371", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5821.0, "discounted_cash": 1164.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 45330 FLEX SIG, DX, W/WO COLLJ SPEC BR/WA SPX", "code_information": [{"code": "45330", "type": "CPT"}, {"code": "102381", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 2236.0, "discounted_cash": 447.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 45331 FLEX SIG W/BX", "code_information": [{"code": "45331", "type": "CPT"}, {"code": "102383", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3646.0, "discounted_cash": 729.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 45332 SGMDSC FLX RMVL FB(S)", "code_information": [{"code": "45332", "type": "CPT"}, {"code": "102385", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3681.0, "discounted_cash": 736.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 45334 SGMDSC FLX W/ CTRL BLD, ANY METHOD", "code_information": [{"code": "45334", "type": "CPT"}, {"code": "102389", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4909.0, 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"billing_class": "facility"}]}, {"description": "HC 45340 SGMDSC FLX DILAT BALO 1/MORE STRIXS", "code_information": [{"code": "45340", "type": "CPT"}, {"code": "102399", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4306.0, "discounted_cash": 861.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 45341 SGMDSC FLX NDSC US XM", "code_information": [{"code": "45341", "type": "CPT"}, {"code": "102401", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 6607.0, "discounted_cash": 1321.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 45342 SGMDSC FLX TNDSC US GID NDL ASPIR/BX", "code_information": [{"code": "45342", "type": "CPT"}, {"code": "102403", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 9108.0, "discounted_cash": 1821.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 45346 SGMDSC FLX W/ ABLTJ LES/TUM/POLYP", "code_information": [{"code": "45346", "type": "CPT"}, {"code": "102397", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5143.0, "discounted_cash": 1028.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 45347 SGMDSC FLX ENDOSCOPIC STENT PLMT", "code_information": [{"code": "45347", "type": "CPT"}, {"code": "102405", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 5429.0, "discounted_cash": 1085.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 45349 SGMDSC FLX NDSCPC MUCOSAL RESECTION", "code_information": [{"code": "45349", "type": "CPT"}, {"code": "179948", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 3678.0, "discounted_cash": 735.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 45350 SGMDSC FLX BAND LIGATION(S)", "code_information": [{"code": 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CATH", "code_information": [{"code": "47540", "type": "CPT"}, {"code": "181482", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 17306.0, "discounted_cash": 3461.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 47541 PLMT ACCESS BIL TREE SM BWL", "code_information": [{"code": "47541", "type": "CPT"}, {"code": "182325", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8108.0, "discounted_cash": 1621.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 47542 BAL DILAT BILIARY DUCT/AMPULLA PRQ EA DUCT", "code_information": [{"code": "47542", "type": "CPT"}, {"code": "238902", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2083.0, "discounted_cash": 416.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 47543 BILIARY TREE BX ENDOLUMINAL", "code_information": [{"code": "47543", "type": "CPT"}, {"code": "212114", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2079.0, "discounted_cash": 415.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 47544 RMVL BILIARY DUCT&/GLBLDR CALCULI PERQ RS&I", "code_information": [{"code": "47544", "type": "CPT"}, {"code": "189077", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 278.0, "discounted_cash": 55.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 47550 BILE DUCT ENDOSCOPY ADD-ON", "code_information": [{"code": "47550", "type": "CPT"}, {"code": "188813", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1977.0, "discounted_cash": 395.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 47553 BILIARY NDSC PRQ T-TUBE W/BX 1/MLT", "code_information": [{"code": "47553", "type": "CPT"}, {"code": "102497", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6219.0, "discounted_cash": 1243.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 47554 BILIARY NDSC PRQ T-TUBE RMVL ST1", "code_information": [{"code": "47554", "type": "CPT"}, {"code": "102499", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 9645.0, "discounted_cash": 1929.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 47555 BILIARY NDSC PRQ T-TUBE DILAT STRIX W/O STENT", "code_information": [{"code": "47555", "type": "CPT"}, {"code": "102501", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4858.0, "discounted_cash": 971.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 47556 BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT", "code_information": [{"code": "47556", "type": "CPT"}, {"code": "102503", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4858.0, "discounted_cash": 971.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 47999 UNLIS PX BILIARY TRACT", "code_information": [{"code": "47999", "type": "CPT"}, {"code": "209230", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4235.0, "discounted_cash": 847.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 48102 BX PNCRS PRQ NDL", "code_information": [{"code": "48102", "type": "CPT"}, {"code": "102507", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2571.0, "discounted_cash": 514.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 48999 UNLIS PX PNCRS", "code_information": [{"code": "48999", "type": "CPT"}, {"code": "102511", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 4611.0, "discounted_cash": 922.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49082 ABD PARACENTESIS W/O IMG GUIDANCE", "code_information": [{"code": "49082", "type": "CPT"}, {"code": "152932", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 1152.0, "discounted_cash": 230.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49083 ABD PARACENTESIS W/IMAGING", "code_information": [{"code": "49083", "type": "CPT"}, {"code": "102521", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2377.0, "discounted_cash": 475.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49180 BX ABDL/RPR MASS PRQ NDL", "code_information": [{"code": "49180", "type": "CPT"}, {"code": "102525", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2583.0, "discounted_cash": 516.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49185 SCLEROTX FLD COLJN PRQ W/IMG GDE", "code_information": [{"code": "49185", "type": "CPT"}, {"code": "227441", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4081.0, "discounted_cash": 816.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49405 IMG FLD COLXN DRN CATH;VISC,PERQ", "code_information": [{"code": "49405", "type": "CPT"}, {"code": "304621", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5122.0, "discounted_cash": 1024.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49406 IMG FLD COLXN DRN CATH;PERI/RETRO,PERQ", "code_information": [{"code": "49406", "type": "CPT"}, {"code": "304623", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5122.0, "discounted_cash": 1024.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49407 IMG FLD COLXN DRAIN CATH TRNSVG/RECTL", "code_information": [{"code": "49407", "type": "CPT"}, {"code": "304625", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3590.0, "discounted_cash": 718.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49411 INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT", "code_information": [{"code": "49411", "type": "CPT"}, {"code": "237999", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3394.0, "discounted_cash": 678.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49418 INSRT TUN IP CATH PERC", "code_information": [{"code": "49418", "type": "CPT"}, {"code": "301418", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 11912.0, "discounted_cash": 2382.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49423 EXCHNG ABSC/CST DRG CATH RAD GID SPX", "code_information": [{"code": "49423", "type": "CPT"}, {"code": "102531", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2744.0, "discounted_cash": 548.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49424 ABSC/CYST CATH INJ", "code_information": [{"code": "49424", "type": "CPT"}, {"code": "163098", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1461.0, "discounted_cash": 292.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49440 INSERT GASTROSTOMY TUBE PERCUTANEOUS", "code_information": [{"code": "49440", "type": "CPT"}, {"code": "102535", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5633.0, "discounted_cash": 1126.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49441 INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ", "code_information": [{"code": "49441", "type": "CPT"}, {"code": "102537", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5633.0, "discounted_cash": 1126.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49450 REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS", "code_information": [{"code": "49450", "type": "CPT"}, {"code": "102543", "type": "CDM"}, {"code": "750", "type": "RC"}], "standard_charges": [{"gross_charge": 952.0, "discounted_cash": 190.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49451 REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ", "code_information": [{"code": "49451", "type": "CPT"}, {"code": "102545", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2153.0, "discounted_cash": 430.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49452 REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS", "code_information": [{"code": "49452", "type": "CPT"}, {"code": "102547", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2153.0, "discounted_cash": 430.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49460 OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE", "code_information": [{"code": "49460", "type": "CPT"}, {"code": "102549", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1426.0, "discounted_cash": 285.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49465 CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE", "code_information": [{"code": "49465", "type": "CPT"}, {"code": "102551", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 143.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49465 INJ CONTRAST/EVAL TUBE W/FLUOR", "code_information": [{"code": "49465", "type": "CPT"}, {"code": "163100", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 716.0, "discounted_cash": 143.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 49999 UNLIS PX ABD PRTM&OMENTUM", "code_information": [{"code": "49999", "type": "CPT"}, {"code": "102553", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5170.0, "discounted_cash": 1034.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50200 RNL BX PRQ TROCAR/NDL", "code_information": [{"code": "50200", "type": "CPT"}, {"code": "102567", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4568.0, "discounted_cash": 913.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50382 RMVL&RPLCMT INTLY DWELLING URTRL STENT", "code_information": [{"code": "50382", "type": "CPT"}, {"code": "102569", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6383.0, "discounted_cash": 1276.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50384 RMVL INTLY DWELLING URTRL STENT", "code_information": [{"code": "50384", "type": "CPT"}, {"code": "102571", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6579.0, "discounted_cash": 1315.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50387 RMVL&RPLCMT XTRNLLY ACCESSIBLE URTRL STENT", "code_information": [{"code": "50387", "type": "CPT"}, {"code": "102573", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3171.0, "discounted_cash": 634.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50389 RMVL NFROS TUBE REQ FLUOR GID", "code_information": [{"code": "50389", "type": "CPT"}, {"code": "102575", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 899.0, "discounted_cash": 179.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50390 ASPIR&/NJX RNL CST/PELVIS NDL PRQ", "code_information": [{"code": "50390", "type": "CPT"}, {"code": "102577", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3661.0, "discounted_cash": 732.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50390 ASPIR&/NJX RNL CST/PELVIS NDL PRQ(59)", "code_information": [{"code": "50390", "type": "CPT"}, {"code": "258542", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3661.0, "discounted_cash": 732.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "59"}, {"description": "HC 50391 INSTLL RX AGNT INTO RNAL TUBE", "code_information": [{"code": "50391", "type": "CPT"}, {"code": "183972", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1765.0, "discounted_cash": 353.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50430 NJX PX NFROSGRM/URTRGRM; NEW ACC", "code_information": [{"code": "50430", "type": "CPT"}, {"code": "181484", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4493.0, "discounted_cash": 898.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50431 NJX PX NFROSGRM/URTRGRM; EXIST ACC", "code_information": [{"code": "50431", "type": "CPT"}, {"code": "181486", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4438.0, "discounted_cash": 887.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50432 PLMT NEPHROSTOMY CATHETER", "code_information": [{"code": "50432", "type": "CPT"}, {"code": "181488", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 13790.0, "discounted_cash": 2758.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50433 PLMT NEPHROURETERAL CATHETER", "code_information": [{"code": "50433", "type": "CPT"}, {"code": "181490", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 13790.0, "discounted_cash": 2758.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50434 CONVERT NEPHROSTOMY CATHETER", "code_information": [{"code": "50434", "type": "CPT"}, {"code": "181492", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2275.0, "discounted_cash": 455.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50435 EXCHANGE NEPHROSTOMY CATH", "code_information": [{"code": "50435", "type": "CPT"}, {"code": "181494", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4070.0, "discounted_cash": 814.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50436 PERC DILAT EXIST TRC, ENDOURLGC PX W/IMG", "code_information": [{"code": "50436", "type": "CPT"}, {"code": "200082", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3853.0, "discounted_cash": 770.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50437 PERC DILAT EXIST TRC, ENDOURLGC PX TUBE PLCMNT NEW ACC RCS W/IMG", "code_information": [{"code": "50437", "type": "CPT"}, {"code": "200084", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4310.0, "discounted_cash": 862.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50592 ABLTJ RENAL TUM(S)PRQ RF UNI", "code_information": [{"code": "50592", "type": "CPT"}, {"code": "102591", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 13016.0, "discounted_cash": 2603.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50593 ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY", "code_information": [{"code": "50593", "type": "CPT"}, {"code": "211239", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 12689.0, "discounted_cash": 2537.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50684 NJX URTRG/URTROPLOG THRU URTROST/URTRL CATH", "code_information": [{"code": "50684", "type": "CPT"}, {"code": "102593", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 684.0, "discounted_cash": 136.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50693 PLMT URETERAL STENT PRQ; PRE EXIST NEPH TRACT", "code_information": [{"code": "50693", "type": "CPT"}, {"code": "181496", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5959.0, "discounted_cash": 1191.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50694 PLMT URETERAL STENT PRQ; NEW W/O NEPH CATH", "code_information": [{"code": "50694", "type": "CPT"}, {"code": "181498", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5959.0, "discounted_cash": 1191.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50695 PLMT URETERAL STENT PRQ; NEW W NEPH CATH", "code_information": [{"code": "50695", "type": "CPT"}, {"code": "181500", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5959.0, "discounted_cash": 1191.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 50706 BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I", "code_information": [{"code": "50706", "type": "CPT"}, {"code": "211638", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2759.0, "discounted_cash": 551.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51080 DRG PRIVESICAL/PREVESICAL SPACE ABSC", "code_information": [{"code": "51080", "type": "CPT"}, {"code": "102597", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 7221.0, "discounted_cash": 1444.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51102 ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER", "code_information": [{"code": "51102", "type": "CPT"}, {"code": "102601", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6465.0, "discounted_cash": 1293.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51600 NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY", "code_information": [{"code": "51600", "type": "CPT"}, {"code": "102603", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1260.0, "discounted_cash": 252.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51610 NJX RTRGR URETHROCSTOGRAPY", "code_information": [{"code": "51610", "type": "CPT"}, {"code": "102605", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 992.0, "discounted_cash": 198.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51700 BLDR IRRIGATION SMPL LVG&/INSTLJ", "code_information": [{"code": "51700", "type": "CPT"}, {"code": "102607", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 393.0, "discounted_cash": 78.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51701 INSJ NON-NDWELLG BLDR CATH", "code_information": [{"code": "51701", "type": "CPT"}, {"code": "102609", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 30.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51702 INSJ TEMP NDWELLG BLDR CATH SMPL", "code_information": [{"code": "51702", "type": "CPT"}, {"code": "102611", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 150.0, "discounted_cash": 30.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51702 INSJ TEMP NDWELLG BLDR CATH SMPL", "code_information": [{"code": "51702", "type": "CPT"}, {"code": "194613", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 874.0, "discounted_cash": 174.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51703 INSJ TEMP NDWELLG BLDR CATH COMP", "code_information": [{"code": "51703", "type": "CPT"}, {"code": "102613", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 63.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51705 CHNG CSTOST TUBE SMPL", "code_information": [{"code": "51705", "type": "CPT"}, {"code": "102615", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 393.0, "discounted_cash": 78.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51710 CHNG CSTOST TUBE COMP", "code_information": [{"code": "51710", "type": "CPT"}, {"code": "102617", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 900.0, "discounted_cash": 180.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51715 ENDOSCOPIC INJECTION/IMPLANT", "code_information": [{"code": "51715", "type": "CPT"}, {"code": "301339", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3226.0, "discounted_cash": 645.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51720 BLDR INSTLJ ANTICARCINOGENIC AGT", "code_information": [{"code": "51720", "type": "CPT"}, {"code": "102619", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 67.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51726 BLADDER PRESSURE MEASUREMENT DURING FILLING", "code_information": [{"code": "51726", "type": "CPT"}, {"code": "102621", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 806.0, "discounted_cash": 161.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51727 CMPLX CYSTOMETROGRAM URETHRAL PRESS PROFILE", "code_information": [{"code": "51727", "type": "CPT"}, {"code": "230405", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 814.0, "discounted_cash": 162.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51728 CYSTOMETROGRAM W/VP", "code_information": [{"code": "51728", "type": "CPT"}, {"code": "102625", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 707.0, "discounted_cash": 141.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51729 CYSTOMETROGRAM W/VP&UP", "code_information": [{"code": "51729", "type": "CPT"}, {"code": "102627", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 800.0, "discounted_cash": 160.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51741 CPLX UROFLOMETRY", "code_information": [{"code": "51741", "type": "CPT"}, {"code": "102629", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 34.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51784 EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL", "code_information": [{"code": "51784", "type": "CPT"}, {"code": "102631", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 34.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51797 VOIDING PRESS STDS INTRA-ABDOMINAL VOID", "code_information": [{"code": "51797", "type": "CPT"}, {"code": "102633", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 55.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 51798 MEAS POST-VOIDING RESIDUAL URINE&/BLDR CAP", "code_information": [{"code": "51798", "type": "CPT"}, {"code": "102636", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 22.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 52000 SCOPE OF BLADDER AND URETHRA, FOR DIAGNOSIS", "code_information": [{"code": "52000", "type": "CPT"}, {"code": "102638", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 730.0, "discounted_cash": 146.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 52005 SCOPE BLADDER, INSERT TUBE FOR INJECTION", "code_information": [{"code": "52005", "type": "CPT"}, {"code": "102642", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1634.0, "discounted_cash": 326.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 52224 CYSTOSCOPY AND TREATMENT", "code_information": [{"code": "52224", "type": "CPT"}, {"code": "250327", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3309.0, "discounted_cash": 661.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 52281 CSTO CALIBRATION DILAT URTL STRIX/STENOSIS", "code_information": [{"code": "52281", "type": "CPT"}, {"code": "102644", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1821.0, "discounted_cash": 364.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 52287 CYSTOSCOPY W/INJ(S) FOR CMTDENERVTJN BLDR", "code_information": [{"code": "52287", "type": "CPT"}, {"code": "180172", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1777.0, "discounted_cash": 355.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 52310 SCOPE BLADDER, SIMPLE REMOVAL STONE, STENT", "code_information": [{"code": "52310", "type": "CPT"}, {"code": "102648", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1821.0, "discounted_cash": 364.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 53020 INCISION OF URETHRA", "code_information": [{"code": "53020", "type": "CPT"}, {"code": "301341", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2310.0, "discounted_cash": 462.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 53600 DILAT URTL STRIX DILATOR MALE INITIAL", "code_information": [{"code": "53600", "type": "CPT"}, {"code": "102658", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 393.0, "discounted_cash": 78.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 53660 DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ 1ST", "code_information": [{"code": "53660", "type": "CPT"}, {"code": "102662", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 39.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 54015 I & D PENIS LESION, DEEP", "code_information": [{"code": "54015", "type": "CPT"}, {"code": "302239", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7461.0, "discounted_cash": 1492.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 54056 DSTRJN LESION(S) PENIS SMPL CHEMICAL", "code_information": [{"code": "54056", "type": "CPT"}, {"code": "181828", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 51.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 54150 CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK", "code_information": [{"code": "54150", "type": "CPT"}, {"code": "102672", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 3357.0, "discounted_cash": 671.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 54162 LYSIS/EXC,PENILE POSTCIRCUM ADHESIONS", "code_information": [{"code": "54162", "type": "CPT"}, {"code": "202097", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2521.0, "discounted_cash": 504.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 54220 CORPORAL DRAINAGE", "code_information": [{"code": "54220", "type": "CPT"}, {"code": "180027", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1320.0, "discounted_cash": 264.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 54235 CORPORAL INJECT W PHARM AGNT", "code_information": [{"code": "54235", "type": "CPT"}, {"code": "180031", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 861.0, "discounted_cash": 172.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 54235 NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT", "code_information": [{"code": "54235", "type": "CPT"}, {"code": "102674", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 464.0, "discounted_cash": 92.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 54450 FORESKN MNPJ W/LSS PREPUTIAL ADS&STRETCHING", "code_information": [{"code": "54450", "type": "CPT"}, {"code": "102676", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1427.0, "discounted_cash": 285.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 54700 I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE", "code_information": [{"code": "54700", "type": "CPT"}, {"code": "102678", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 10165.0, "discounted_cash": 2033.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 55000 PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED", "code_information": [{"code": "55000", "type": "CPT"}, {"code": "217249", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 884.0, "discounted_cash": 176.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 55100 DRG SCROTAL WALL ABSC", "code_information": [{"code": "55100", "type": "CPT"}, {"code": "102682", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2067.0, "discounted_cash": 413.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 55700 PROSTATE NEEDLE BIOPSY, ANY APPROACH", "code_information": [{"code": "55700", "type": "CPT"}, {"code": "102686", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2634.0, "discounted_cash": 526.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 55876 PLACEMENT NTRSTL DEVICE RAD GID PROSTATE 1/>", "code_information": [{"code": "55876", "type": "CPT"}, {"code": "102688", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1678.0, "discounted_cash": 335.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 55899 UNLIS MALE GEN SYS", "code_information": [{"code": "55899", "type": "CPT"}, {"code": "102690", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4923.0, "discounted_cash": 984.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 56405 I&D VULVA/PRNL ABSC", "code_information": [{"code": "56405", "type": "CPT"}, {"code": "102692", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 100.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 56420 I&D OF BARTHOLIN/'S GLAND ABSC", "code_information": [{"code": "56420", "type": "CPT"}, {"code": "102694", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1895.0, "discounted_cash": 379.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 56440 MARSUPIALIZATION BARTHOLIN/'S GLAND CYST", "code_information": [{"code": "56440", "type": "CPT"}, {"code": "227056", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7075.0, "discounted_cash": 1415.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 56606 BIOPSY VULVA/PERINEUM; EA ADD'L LESION", "code_information": [{"code": "56606", "type": "CPT"}, {"code": "185715", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 195.0, "discounted_cash": 39.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 57000 COLPOTOMY W/EXPL", "code_information": [{"code": "57000", "type": "CPT"}, {"code": "102698", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5130.0, "discounted_cash": 1026.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 57061 DSTRJ VAG LES SMPL", "code_information": [{"code": "57061", "type": "CPT"}, {"code": "102700", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 9815.0, "discounted_cash": 1963.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 57160 FITG&INSJ PESSARY/OTH INTRAVAG SUPPORT DEV", "code_information": [{"code": "57160", "type": "CPT"}, {"code": "102702", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 47.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 57180 INTRO ANY HEMOSTATIC AGT/PACK VAG HEMRRG SPX", "code_information": [{"code": "57180", "type": "CPT"}, {"code": "102704", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1533.0, "discounted_cash": 306.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 57200 LACERATION VAGINA", "code_information": [{"code": "57200", "type": "CPT"}, {"code": "296134", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5640.0, "discounted_cash": 1128.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 57420 COLPOSCOPY VAGINA", "code_information": [{"code": "57420", "type": "CPT"}, {"code": "302268", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 389.0, "discounted_cash": 77.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 57452 FN: SA EXAM W COLPOSCOPE", "code_information": [{"code": "57452", "type": "CPT"}, {"code": "170250", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 233.0, "discounted_cash": 46.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 58100 ENDOMETRIAL BX -ENDOCRV BX W/O DILAT SPX", "code_information": [{"code": "58100", "type": "CPT"}, {"code": "102716", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 252.0, "discounted_cash": 50.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 58301 RMVL INTRAUTERINE DEV", "code_information": [{"code": "58301", "type": "CPT"}, {"code": "102718", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 83.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 58340 CATHJ&INTRO SALINE NFS SHG/HSG", "code_information": [{"code": "58340", "type": "CPT"}, {"code": "102720", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1165.0, "discounted_cash": 233.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59000 AMNIOCENTESIS DX", "code_information": [{"code": "59000", "type": "CPT"}, {"code": "102724", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1668.0, "discounted_cash": 333.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59020 FTL CONTRCJ STRS TST", "code_information": [{"code": "59020", "type": "CPT"}, {"code": "102726", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 1084.0, "discounted_cash": 216.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59025 FTL NON-STRS TST", "code_information": [{"code": "59025", "type": "CPT"}, {"code": "102728", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 874.0, "discounted_cash": 174.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59070 AMNIOINFUSION", "code_information": [{"code": "59070", "type": "CPT"}, {"code": "254525", "type": "CDM"}, {"code": "720", "type": "RC"}], "standard_charges": [{"gross_charge": 604.0, "discounted_cash": 120.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59160 DILATION AND CURETTAGE, POSTPARTUM", "code_information": [{"code": "59160", "type": "CPT"}, {"code": "184834", "type": "CDM"}, {"code": "722", "type": "RC"}], "standard_charges": [{"gross_charge": 6003.0, "discounted_cash": 1200.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59200 INSERT CERVICAL DILATOR", "code_information": [{"code": "59200", "type": "CPT"}, {"code": "295420", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1994.0, "discounted_cash": 398.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59300 EPISIOTOMY SPX (HOME/OTHR DELIVERY)", "code_information": [{"code": "59300", "type": "CPT"}, {"code": "302237", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 8220.0, "discounted_cash": 1644.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59300 EPISIOTOMY/VAGINAL RPR", "code_information": [{"code": "59300", "type": "CPT"}, {"code": "211045", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6388.0, "discounted_cash": 1277.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59320 CERCLAGE PLACEMENT", "code_information": [{"code": "59320", "type": "CPT"}, {"code": "254527", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 9974.0, "discounted_cash": 1994.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59409 VAGINAL DELIVERY ONLY (W/WO EPISIOTOMY &/OR FORCEPS)", "code_information": [{"code": "59409", "type": "CPT"}, {"code": "192262", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7179.0, "discounted_cash": 1435.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59412 ANTEPARTUM MANIPULATION", "code_information": [{"code": "59412", "type": "CPT"}, {"code": "295388", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2410.0, "discounted_cash": 482.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59414 DLVR PLACENTA SPX", "code_information": [{"code": "59414", "type": "CPT"}, {"code": "102732", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8220.0, "discounted_cash": 1644.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 59871 RMVL CERCLAGE SUTURE UNDER ANESTHESIA", "code_information": [{"code": "59871", "type": "CPT"}, {"code": "217128", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 8506.0, "discounted_cash": 1701.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 60100 BX THYR PRQ CORE NDL", "code_information": [{"code": "60100", "type": "CPT"}, {"code": "102746", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": 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1648.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 61626 TCAT PRM OCCLUSION/EMBOLIZATION PRQ NON-CNS", "code_information": [{"code": "61626", "type": "CPT"}, {"code": "102758", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8214.0, "discounted_cash": 1642.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 61630 BALO ANGIOP ICRA PRQ", "code_information": [{"code": "61630", "type": "CPT"}, {"code": "102760", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8213.0, "discounted_cash": 1642.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 61635 TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD", "code_information": [{"code": "61635", "type": "CPT"}, {"code": "102762", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7833.0, "discounted_cash": 1566.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 61640 BALO DILAT ICRA PRQ 1ST VSL", "code_information": [{"code": "61640", "type": "CPT"}, {"code": "102764", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8213.0, "discounted_cash": 1642.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 61641 BALO DILAT ICRA PRQ EA VSL SM VASC TER", "code_information": [{"code": "61641", "type": "CPT"}, {"code": "102766", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8775.0, "discounted_cash": 1755.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 61642 BALO DILAT ICRA PRQ EA VSL DIFF VASC TER", "code_information": [{"code": "61642", "type": "CPT"}, {"code": "102768", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4961.0, "discounted_cash": 992.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 61645 PERQ ART MECH-THROMBECT INTRACRANIAL", "code_information": [{"code": "61645", "type": "CPT"}, {"code": "184540", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 8298.0, "discounted_cash": 1659.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62264 PRQ LSS EDRL ADS SLN NJX/MCHNL LOCLZJ 1 D", "code_information": [{"code": "62264", "type": "CPT"}, {"code": "102772", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 8498.0, "discounted_cash": 1699.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62267 PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS", "code_information": [{"code": "62267", "type": "CPT"}, {"code": "102774", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 5250.0, "discounted_cash": 1050.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62270 SPI PNXR LMBR DX", 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"type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4466.0, "discounted_cash": 893.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62282 INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL", "code_information": [{"code": "62282", "type": "CPT"}, {"code": "178604", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2747.0, "discounted_cash": 549.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62284 INJ PROC MYELOGRAPHY/CT LUMBAR", "code_information": [{"code": "62284", "type": "CPT"}, {"code": "179956", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2769.0, "discounted_cash": 553.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62290 NJX DISKOGRAPY EA LVL LMBR", "code_information": [{"code": "62290", "type": "CPT"}, {"code": "102792", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1214.0, "discounted_cash": 242.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62291 NJX DISKOGRAPY EA LVL CRV/THRC", "code_information": [{"code": "62291", "type": "CPT"}, {"code": "102794", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 1620.0, "discounted_cash": 324.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62302 MYELOGRAPHY,LUMBAR INJ,S&I;CERVICAL", "code_information": [{"code": "62302", "type": "CPT"}, {"code": "179958", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6598.0, "discounted_cash": 1319.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62303 MYELOGRAPHY,LUMBAR INJ,S&I;THORACIC", "code_information": [{"code": "62303", "type": "CPT"}, {"code": "179960", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6598.0, "discounted_cash": 1319.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62304 MYELOGRAPHY,LUMBAR INJ,S&I;LUMBOSACRAL", "code_information": [{"code": "62304", "type": "CPT"}, {"code": "179962", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6598.0, "discounted_cash": 1319.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62305 MYELOGRAPHY,LUMBAR INJ,S&I;>=2 RGNS", "code_information": [{"code": "62305", "type": "CPT"}, {"code": "179964", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 7929.0, "discounted_cash": 1585.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62321 NJX C-DX/THER SBST EDRL/SARACH CRV/THRC", "code_information": [{"code": "62321", "type": "CPT"}, {"code": "186611", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5324.0, "discounted_cash": 1064.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62323 NJX C-DX/THER SBST EDRL/SARACH LMBR SAC", "code_information": [{"code": "62323", "type": "CPT"}, {"code": "186621", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6209.0, "discounted_cash": 1241.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62325 NJX NFS/BOLUS DX/SBST EDRL/SARACH CRV/THRC", "code_information": [{"code": "62325", "type": "CPT"}, {"code": "186632", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5617.0, "discounted_cash": 1123.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62326 INSERTION OF CATHETER, ADMIN SUBSTANCE LOW BACK W/OUT IMAGE", "code_information": [{"code": "62326", "type": "CPT"}, {"code": "188617", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 3959.0, "discounted_cash": 791.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62327 NJX NFS/BOLUS DX/SBST EDRL/SARACH LMBR SAC", "code_information": [{"code": "62327", "type": "CPT"}, {"code": "186640", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3444.0, "discounted_cash": 688.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62328 DX LMBR SPI PNXR W/FLUOR/CT", "code_information": [{"code": "62328", "type": "CPT"}, {"code": "214847", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3114.0, "discounted_cash": 622.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62329 THER LMBR SPI PNXR W/FLUOR/CT", "code_information": [{"code": "62329", "type": "CPT"}, {"code": "217243", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2734.0, "discounted_cash": 546.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62350 IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM", "code_information": [{"code": "62350", "type": "CPT"}, {"code": "178606", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10860.0, "discounted_cash": 2172.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62367 ELEC ALYS PRGRBL PMP W/O REPRGRMG", "code_information": [{"code": "62367", "type": "CPT"}, {"code": "102808", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 389.0, "discounted_cash": 77.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62368 ELEC ALYS PRGRBL PMP REPRGRMG", "code_information": [{"code": "62368", "type": "CPT"}, {"code": "102810", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 413.0, "discounted_cash": 82.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62369 PUMP ANALY W PROG/REFILL", "code_information": [{"code": "62369", "type": "CPT"}, {"code": "254531", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 72.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62370 PUMP ANALY W PROG/REFILL,PHY SKILL", "code_information": [{"code": "62370", "type": "CPT"}, {"code": "210081", "type": "CDM"}, {"code": "940", "type": "RC"}], "standard_charges": [{"gross_charge": 2899.0, "discounted_cash": 579.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 62380 NDSC DCMPRN SPINAL CORD 1 W/LAMOT NTRSPC LUMBAR", "code_information": [{"code": "62380", "type": "CPT"}, {"code": "178608", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16660.0, "discounted_cash": 3332.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 63650 PRQ IMPLTJ NSTIM ELTRD RA EDRL", "code_information": [{"code": "63650", "type": "CPT"}, {"code": "102824", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 12146.0, "discounted_cash": 2429.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 63663 REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR", "code_information": [{"code": "63663", "type": "CPT"}, {"code": "178610", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 16741.0, "discounted_cash": 3348.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64400 NJX ANES AGNT/STEROID TRIGEMINAL NRV EA BRANCH", "code_information": [{"code": "64400", "type": "CPT"}, {"code": "102836", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 76.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64405 NJX ANES AGNT/STEROID GRTER OCCIPITAL NRV", "code_information": [{"code": "64405", "type": "CPT"}, {"code": "102840", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 554.0, "discounted_cash": 110.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64415 INJ ANES AGNT/STERIOD; BRACHIAL PLXS IMG GDN", "code_information": [{"code": "64415", "type": "CPT"}, {"code": "199782", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2652.0, "discounted_cash": 530.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64417 INJ ANES AGNT/STERIOD; AXILLARY NRV IMG GDN", "code_information": [{"code": "64417", "type": "CPT"}, {"code": "199788", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2652.0, "discounted_cash": 530.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64417 INJ ANES AGNT/STERIOD; AXILLARY NRV IMG GDN", "code_information": [{"code": "64417", "type": "CPT"}, {"code": "199792", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2652.0, "discounted_cash": 530.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64417 NJX ANES AX NRV", "code_information": [{"code": "64417", "type": "CPT"}, {"code": "102844", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2652.0, "discounted_cash": 530.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64418 NJX ANES AGNT/STEROID SUPRASCAPULAR NRV", "code_information": [{"code": "64418", "type": "CPT"}, {"code": "102846", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 932.0, "discounted_cash": 186.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64420 NJX ANES AGNT/STEROID INTERCOSTAL NRV SNGL LVL", "code_information": [{"code": "64420", "type": "CPT"}, {"code": "102848", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5555.0, "discounted_cash": 1111.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64421 NJX ANES AGNT/STEROID INTERCOSTAL NRV EA ADDL LVL", "code_information": [{"code": "64421", "type": "CPT"}, {"code": "102850", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 10136.0, "discounted_cash": 2027.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64425 NJX ANES AGNT/STEROID ILIOINGUN ILIOHYPOGSTR NRV", "code_information": [{"code": "64425", "type": "CPT"}, {"code": "102852", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 868.0, "discounted_cash": 173.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64430 NJX ANES AGNT/STEROID PUDENDAL NRV", "code_information": [{"code": "64430", "type": "CPT"}, {"code": "102854", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2448.0, "discounted_cash": 489.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64445 INJ ANES AGNT/STERIOD; SCIATIC NRV IMG GDN", "code_information": [{"code": "64445", "type": "CPT"}, {"code": "199796", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2652.0, "discounted_cash": 530.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64447 INJ ANES AGNT/STERIOD; FEMORAL NRV IMG GDN", "code_information": [{"code": "64447", "type": "CPT"}, {"code": "199804", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 2652.0, "discounted_cash": 530.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64447 INJ ANES AGNT/STERIOD; FEMORAL NRV IMG GDN", "code_information": [{"code": "64447", "type": "CPT"}, {"code": "199808", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2440.0, "discounted_cash": 488.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64447 NJX ANES AGNT/STEROID FEMORAL NRV", "code_information": [{"code": "64447", "type": "CPT"}, {"code": "102858", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2440.0, "discounted_cash": 488.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64449 NJX ANES AGNT/STEROID LUMBAR PLEXUS POST CONT NFS CATH", "code_information": [{"code": "64449", "type": "CPT"}, {"code": "102860", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4514.0, "discounted_cash": 902.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64450 NJX ANES AGNT/STEROID OTH PRPH NRV/BRANCH", "code_information": [{"code": "64450", "type": "CPT"}, {"code": "102862", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 186.6, "setting": "outpatient", "billing_class": "facility"}]}, 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EDRL CRV/THRC 1 LVL", "code_information": [{"code": "64479", "type": "CPT"}, {"code": "102866", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6897.0, "discounted_cash": 1379.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64480 NJX ANES&/STRD TFRML EDRL CRV/THRC EA LVL", "code_information": [{"code": "64480", "type": "CPT"}, {"code": "102868", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 4492.0, "discounted_cash": 898.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64483 NJX ANES&/STRD TFRML EDRL LMBR/SAC 1 LVL", "code_information": [{"code": "64483", "type": "CPT"}, {"code": "102870", "type": "CDM"}, {"code": "361", "type": "RC"}], "standard_charges": [{"gross_charge": 6897.0, "discounted_cash": 1379.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64484 NJX ANES&/STRD TFRML EDRL LMBR/SAC EA LVL", "code_information": [{"code": "64484", "type": "CPT"}, {"code": "102872", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4492.0, "discounted_cash": 898.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64490 INJ A/ST PVERT FCT JNT/NV;C/TH SGL LEV", "code_information": [{"code": "64490", "type": "CPT"}, {"code": "102874", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7779.0, "discounted_cash": 1555.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64491 INJ A/ST PVERT FCT JNT/NV;C/TH 2 LEV", "code_information": [{"code": "64491", "type": "CPT"}, {"code": "102876", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3089.0, "discounted_cash": 617.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64492 INJ A/ST PVERT FCT JNT/NV;C/TH 3 LEV", "code_information": [{"code": "64492", "type": "CPT"}, {"code": "102878", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2160.0, "discounted_cash": 432.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64493 INJ A/ST PVERT FCT JNT/NV;L/S SGL LEV", "code_information": [{"code": "64493", "type": "CPT"}, {"code": "102880", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7779.0, "discounted_cash": 1555.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64494 INJ A/ST PVERT FCT JNT/NV;L/S 2 LEV", "code_information": [{"code": "64494", "type": "CPT"}, {"code": "102882", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3089.0, "discounted_cash": 617.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64495 INJ A/ST PVERT FCT JNT/NV;L/S 3 LEV", "code_information": [{"code": "64495", "type": "CPT"}, {"code": "102884", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 3089.0, "discounted_cash": 617.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64505 NJX ANES SPHENOPALATINE GANGLION", "code_information": [{"code": "64505", "type": "CPT"}, {"code": "102886", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5175.0, "discounted_cash": 1035.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64510 NJX ANES STELLATE GANGLION CRV SYMPATHETIC", "code_information": [{"code": "64510", "type": "CPT"}, {"code": "102888", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 6113.0, "discounted_cash": 1222.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64517 NJX ANES SUPRIOR HYPOGSTR PLEXUS", "code_information": [{"code": "64517", "type": "CPT"}, {"code": "102890", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 4338.0, "discounted_cash": 867.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64520 NJX ANES LMBR/THRC PVRT SYMPATHETIC", "code_information": [{"code": "64520", "type": "CPT"}, {"code": "102892", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5324.0, "discounted_cash": 1064.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64530 NJX ANES CELIAC PLEXUS -RAD MNTR", "code_information": [{"code": "64530", "type": "CPT"}, {"code": "102894", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5857.0, "discounted_cash": 1171.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64561 PRQ IMPLTJ NSTIM ELTRDS SAC NRV", "code_information": [{"code": "64561", "type": "CPT"}, {"code": "102900", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7691.0, "discounted_cash": 1538.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64566 POST TIB NEUROSTM, PERC NDL ELTRD, SNGL TMT", "code_information": [{"code": "64566", "type": "CPT"}, {"code": "184832", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 67.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64610 DSTRJ NULYT TRIGEMINAL NRV 2/3 DIV RAD MNTR", "code_information": [{"code": "64610", "type": "CPT"}, {"code": "102908", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7834.0, "discounted_cash": 1566.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64611 CHEMODENERV SALIV GLANDS", "code_information": [{"code": "64611", "type": "CPT"}, {"code": "230512", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 67.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64612 DESTROY NERVE, FACIAL", "code_information": [{"code": "64612", "type": "CPT"}, {"code": "226641", "type": "CDM"}, {"code": "940", "type": "RC"}], "standard_charges": [{"gross_charge": 386.0, "discounted_cash": 77.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64615 DESTROY NERVE, FACIAL,TRIGEM,CRV,ACC, BILAT", "code_information": [{"code": "64615", "type": "CPT"}, {"code": "295424", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 389.0, "discounted_cash": 77.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64616 CHEMODENERV MUSC NECK DYSTON", "code_information": [{"code": "64616", "type": "CPT"}, {"code": "304690", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 554.0, "discounted_cash": 110.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64620 DSTRJ NULYT INTERCOSTAL NRV", "code_information": [{"code": "64620", "type": "CPT"}, {"code": "102914", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5324.0, "discounted_cash": 1064.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64624 DSTRJ NULYT AGT GNCLR NRV", "code_information": [{"code": "64624", "type": "CPT"}, {"code": "218815", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1950.0, "discounted_cash": 390.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64625 RF ABLTJ NRV NRVTG SI JT W/IMG GDE", "code_information": [{"code": "64625", "type": "CPT"}, {"code": "217330", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7076.0, "discounted_cash": 1415.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64633 DSTRJ NULYT PVRT FACET JT NRV CRV/THRC 1 LEV", "code_information": [{"code": "64633", "type": "CPT"}, {"code": "102920", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7059.0, "discounted_cash": 1411.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64634 DSTRJ NULYT PVRT FACET JT NRV CRV/THRC EA ADD LEV", "code_information": [{"code": "64634", "type": "CPT"}, {"code": "102922", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2662.0, "discounted_cash": 532.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64635 DSTRJ NULYT PVRT FACET JT NRV LMBR/SAC 1 LEV", "code_information": [{"code": "64635", "type": "CPT"}, {"code": "102916", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 7059.0, "discounted_cash": 1411.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64636 DSTRJ NULYT PVRT FACET JT NRV LMBR/SAC EA ADD LEV", "code_information": [{"code": "64636", "type": "CPT"}, {"code": "102918", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2690.0, "discounted_cash": 538.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64640 DSTRJ NULYT OTH PRPH NRV/BRANCH", "code_information": [{"code": "64640", "type": "CPT"}, {"code": "102926", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 1110.0, "discounted_cash": 222.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64642 CHEMODENERV 1 EXTREMITY 1-4", "code_information": [{"code": "64642", "type": "CPT"}, {"code": "304692", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 849.0, "discounted_cash": 169.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64643 CHEMODENERV 1 EXTREM 1-4 EA ADDL EXTR", "code_information": [{"code": "64643", "type": "CPT"}, {"code": "304694", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 523.0, "discounted_cash": 104.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64644 CHEMODENERV 1 EXTREM 5/> MUS", "code_information": [{"code": "64644", "type": "CPT"}, {"code": "304632", "type": "CDM"}, {"code": "940", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 186.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64645 CHEMODENERV 1 EXTREM 5/> EA ADDL EXTR", "code_information": [{"code": "64645", "type": "CPT"}, {"code": "304634", "type": "CDM"}, {"code": "940", "type": "RC"}], "standard_charges": [{"gross_charge": 523.0, "discounted_cash": 104.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64646 CHEMODENERV TRUNK MUSC 1-5", "code_information": [{"code": "64646", "type": "CPT"}, {"code": "304636", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 933.0, "discounted_cash": 186.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64647 CHEMODENERV TRUNK MUSC 6/>", "code_information": [{"code": "64647", "type": "CPT"}, {"code": "304638", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 157.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64680 DSTRJ NULYT -RAD MNTR CELIAC PLEXUS", "code_information": [{"code": "64680", "type": "CPT"}, {"code": "102928", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 5324.0, "discounted_cash": 1064.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 64999 UNLIS PX NRVS SYS", "code_information": [{"code": "64999", "type": "CPT"}, {"code": "102932", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 2638.0, "discounted_cash": 527.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 65205 RMVL FB XTRNL EYE CJNCL SUPFC", "code_information": [{"code": "65205", "type": "CPT"}, {"code": "102934", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 20.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 65210 RMVL FB XTRNL EYE EMBEDDED SCJNCL/SCLL NONPRF8", "code_information": [{"code": "65210", "type": "CPT"}, {"code": "102936", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 66.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 65220 RMVL FB XTRNL EYE CRNL W/O SLIT LAMP", "code_information": [{"code": "65220", "type": "CPT"}, {"code": "102938", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 66.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 65222 RMVL FB XTRNL EYE CRNL W/SLIT LAMP", "code_information": [{"code": "65222", "type": "CPT"}, {"code": "102940", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 104.0, "discounted_cash": 20.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 65280 REPAIR LACERATION CORNEA AND SCLERA", "code_information": [{"code": "65280", "type": "CPT"}, {"code": "230716", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 8837.0, "discounted_cash": 1767.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 65286 RPR LAC;APPLY TIS GLUE,CORN/SLERA", "code_information": [{"code": "65286", "type": "CPT"}, {"code": "304715", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1942.0, "discounted_cash": 388.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 65430 SCRAPING CRN DX F/SMR&/CULTURE", "code_information": [{"code": "65430", "type": "CPT"}, {"code": "102950", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 66.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 65435 RMVL CRNL EPITHE-CMTCAUT", "code_information": [{"code": "65435", "type": "CPT"}, {"code": "177413", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 826.0, "discounted_cash": 165.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 65436 RMVL CRNL EPITHE W/APPL CHELATING AGT", "code_information": [{"code": "65436", "type": "CPT"}, {"code": "102952", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1812.0, "discounted_cash": 362.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 65800 PARACENTESIS ANT CHMBR EYE; RMVL AQUEOUS", "code_information": [{"code": "65800", "type": "CPT"}, {"code": "186500", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 2035.0, "discounted_cash": 407.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 65855 TRABECULOPLASTY LASER SURG", "code_information": [{"code": "65855", "type": "CPT"}, {"code": "102956", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 117.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 66250 EVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT", "code_information": [{"code": "66250", "type": "CPT"}, {"code": "177268", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2153.0, "discounted_cash": 430.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 66761 IRIDOTOMY/IRDEC LASER SURG 1 SESS", "code_information": [{"code": "66761", "type": "CPT"}, {"code": "102960", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 117.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 66821 POST-CATARACT LASER SURGERY", "code_information": [{"code": "66821", "type": "CPT"}, {"code": "102962", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 117.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 66999 UNLIS ANT SGM EYE", "code_information": [{"code": "66999", "type": "CPT"}, {"code": "102964", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 7267.0, "discounted_cash": 1453.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67015 ASP/RELEASE VITREOUS SUBRETINAL/CHOROIDA", "code_information": [{"code": "67015", "type": "CPT"}, {"code": "187412", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2516.0, "discounted_cash": 503.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67028 INTRAVITREAL NJX PHARMACOLOGIC AGT SPX", "code_information": [{"code": "67028", "type": "CPT"}, {"code": "102966", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 68.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67110 RPR RTA DTCHMNT NJX AIR/OTH GAS", "code_information": [{"code": "67110", "type": "CPT"}, {"code": "102970", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2426.0, "discounted_cash": 485.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67145 PROPH RTA DTCHMNT W/O DRG", "code_information": [{"code": "67145", "type": "CPT"}, {"code": "102974", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 117.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67210 DSTRJ LOCLZD LES RETINA 1 SESS PC", "code_information": [{"code": "67210", "type": "CPT"}, {"code": "102976", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 117.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67220 DSTRJ LESION CHOROID PC 1/> SESS", "code_information": [{"code": "67220", "type": "CPT"}, {"code": "180169", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 100.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67228 EXTENSIVE RETINOPATHY PHOTOCOAGULATION", "code_information": [{"code": "67228", "type": "CPT"}, {"code": "102978", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 585.0, "discounted_cash": 117.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67229 EXT TMT RETINOPATHY 1/> SESS PRETERM INF", "code_information": [{"code": "67229", "type": "CPT"}, {"code": "249456", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 2617.0, "discounted_cash": 523.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67515 NJX MED/OTHER SBST TENON/'S CAPSULE", "code_information": [{"code": "67515", "type": "CPT"}, {"code": "102982", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 68.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67700 BLEPHAROTOMY DRG ABSC EYELID", "code_information": [{"code": "67700", "type": "CPT"}, {"code": "102984", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 452.0, "discounted_cash": 90.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67715 CANTHOTOMY", "code_information": [{"code": "67715", "type": "CPT"}, {"code": "211028", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 4116.0, "discounted_cash": 823.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67800 EXC CHALAZION 1", "code_information": [{"code": "67800", "type": "CPT"}, {"code": "102986", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 68.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67801 EXC CHALAZION MULTI SAME LID", "code_information": [{"code": "67801", "type": "CPT"}, {"code": "184366", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 826.0, "discounted_cash": 165.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67805 EXC CHALAZION MLT DIFF LIDS", "code_information": [{"code": "67805", "type": "CPT"}, {"code": "102988", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 294.0, "discounted_cash": 58.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67820 CORRJ TRICHIASIS EPILATION FORCEPS ONLY", "code_information": [{"code": "67820", "type": "CPT"}, {"code": "102992", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 28.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67875 TEMP SUTR CLSRE EYELID", "code_information": [{"code": "67875", "type": "CPT"}, {"code": "302264", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1171.0, "discounted_cash": 234.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67930 SUTR RECENT WND EYELID PRTL THKNS", "code_information": [{"code": "67930", "type": "CPT"}, {"code": "102994", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6010.0, "discounted_cash": 1202.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67935 SUTR RECENT WND EYELID FULL THKNS", "code_information": [{"code": "67935", "type": "CPT"}, {"code": "226474", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 6720.0, "discounted_cash": 1344.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67938 RMVL EMBEDDED FB EYELID", "code_information": [{"code": "67938", "type": "CPT"}, {"code": "102996", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 982.0, "discounted_cash": 196.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 67961 EXC RPR EYELID", "code_information": [{"code": "67961", "type": "CPT"}, {"code": "302262", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1924.0, "discounted_cash": 384.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 68200 SUBCONJUNCTIVAL INJECTION", "code_information": [{"code": "68200", "type": "CPT"}, {"code": "304717", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 248.0, "discounted_cash": 49.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 68761 CLSR LACRIMAL PUNCTUM PLUG EA", "code_information": [{"code": "68761", "type": "CPT"}, {"code": "103006", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 68.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 68801 DILAT LACRIMAL PUNCTUM -IRRG", "code_information": [{"code": "68801", "type": "CPT"}, {"code": "103008", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 390.0, "discounted_cash": 78.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 68810 PROBE NASOLACRIMAL DUX -IRRG", "code_information": [{"code": "68810", "type": "CPT"}, {"code": "103010", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 59.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 69000 DRG XTRNL EAR ABSC/HMTMA SMPL", "code_information": [{"code": "69000", "type": "CPT"}, {"code": "103012", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1132.0, "discounted_cash": 226.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 69000 DRG XTRNL EAR ABSC/HMTMA SMPL", "code_information": [{"code": "69000", "type": "CPT"}, {"code": "195646", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1132.0, "discounted_cash": 226.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 69005 DRG XTRNL EAR ABSC/HMTMA COMP", "code_information": [{"code": "69005", "type": "CPT"}, {"code": "103014", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 5686.0, "discounted_cash": 1137.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 69020 DRG XTRNL AUD CANAL ABSC", "code_information": [{"code": "69020", "type": "CPT"}, {"code": "103016", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 1079.0, "discounted_cash": 215.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 69200 RMVL FB XTRNL AUD CANAL W/O ANES", "code_information": [{"code": "69200", "type": "CPT"}, {"code": "103020", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 33.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 69209 RMVL IMPCTD CERUMEN IRRG/LAVG", "code_information": [{"code": "69209", "type": "CPT"}, {"code": "183259", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 88.0, "discounted_cash": 17.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 69210 RMVL IMPCTD CERUMEN SPX UNILATERAL", "code_information": [{"code": "69210", "type": "CPT"}, {"code": "103024", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 20.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 69220 DBRDMT MSTDC CAVITY SMPL", "code_information": [{"code": "69220", "type": "CPT"}, {"code": "103026", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 69222 DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX", "code_information": [{"code": "69222", "type": "CPT"}, {"code": "188833", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 714.0, "discounted_cash": 142.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 69420 MRGT ASPIR&/EUSTACHIAN TUBE NFLTJ", "code_information": 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"761", "type": "RC"}], "standard_charges": [{"gross_charge": 3190.0, "discounted_cash": 638.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70030 DX- FOREIGN BODY ORBIT", "code_information": [{"code": "70030", "type": "CPT"}, {"code": "103038", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 462.0, "discounted_cash": 92.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70100 DX- JAW/MANDIBLE < 4 VW", "code_information": [{"code": "70100", "type": "CPT"}, {"code": "103040", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 897.0, "discounted_cash": 179.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70110 DX- JAW/MANDIBLE MIN 4VW", "code_information": [{"code": "70110", "type": "CPT"}, {"code": "103042", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 924.0, "discounted_cash": 184.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70130 DX- MASTOID CMPL MIN 3V PER SD", "code_information": [{"code": "70130", "type": "CPT"}, {"code": "103046", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 664.0, "discounted_cash": 132.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70140 DX- FACIAL BONES < 3VW", "code_information": [{"code": "70140", "type": "CPT"}, {"code": "103048", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 892.0, "discounted_cash": 178.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70150 DX- FACIAL BONES MIN 3VW", "code_information": [{"code": "70150", "type": "CPT"}, {"code": "103050", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 936.0, "discounted_cash": 187.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70160 DX- NASAL BONES MIN 3VW", "code_information": [{"code": "70160", "type": "CPT"}, {"code": "103052", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 735.0, "discounted_cash": 147.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70200 DX- ORBITS MIN 4VW", "code_information": [{"code": "70200", "type": "CPT"}, {"code": "103058", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 927.0, "discounted_cash": 185.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70210 DX- SINUSES < 3VW", "code_information": [{"code": "70210", "type": "CPT"}, {"code": "103060", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 561.0, "discounted_cash": 112.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70220 DX- SINUS PARANASAL MIN 3VW", "code_information": [{"code": "70220", "type": "CPT"}, {"code": "103062", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 974.0, "discounted_cash": 194.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70250 DX- SKULL< 4VW", "code_information": [{"code": "70250", "type": "CPT"}, {"code": "103066", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 812.0, "discounted_cash": 162.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70260 DX- SKULL MIN 4VW", "code_information": [{"code": "70260", "type": "CPT"}, {"code": "103068", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1072.0, "discounted_cash": 214.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70328 DX- TMJ OPEN/CLOSE-UNILAT", "code_information": [{"code": "70328", "type": "CPT"}, {"code": "103070", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 606.0, "discounted_cash": 121.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70330 DX- TMJ OPEN/CLOSE-BILAT", "code_information": [{"code": "70330", "type": "CPT"}, {"code": "103072", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 823.0, "discounted_cash": 164.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70336 MRI TEMPROMANDIBULAR JOINTS", "code_information": [{"code": "70336", "type": "CPT"}, {"code": "103076", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 5525.0, "discounted_cash": 1105.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70360 DX- C-SPINE SOFT TISSUE", "code_information": [{"code": "70360", "type": "CPT"}, {"code": "103078", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 143.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70450 CT BRAIN LAB W/O CONTRAST", "code_information": [{"code": "70450", "type": "CPT"}, {"code": "163119", "type": "CDM"}, {"code": "351", "type": "RC"}], "standard_charges": [{"gross_charge": 4716.0, "discounted_cash": 943.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70450 CT HEAD/BRAIN W/O CONTRAST", "code_information": [{"code": "70450", "type": "CPT"}, {"code": "103084", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4716.0, "discounted_cash": 943.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70450 CT SRS, HEAD/BRAIN WO CONTRAST", "code_information": [{"code": "70450", "type": "CPT"}, {"code": "163117", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4716.0, "discounted_cash": 943.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70460 CT BRAIN LAB W/CONTRAST", "code_information": 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{"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6914.0, "discounted_cash": 1382.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70470 CT SRS, HEAD/BRAIN W&WO CONTRA", "code_information": [{"code": "70470", "type": "CPT"}, {"code": "163125", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 6914.0, "discounted_cash": 1382.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70480 CT IAC WO CONTRAST", "code_information": [{"code": "70480", "type": "CPT"}, {"code": "163131", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": [{"gross_charge": 4447.0, "discounted_cash": 889.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 70480 CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST", "code_information": [{"code": "70480", "type": "CPT"}, {"code": "103090", "type": "CDM"}, {"code": "350", "type": "RC"}], "standard_charges": 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"type": "RC"}], "standard_charges": [{"gross_charge": 17365.0, "discounted_cash": 3473.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77021 MRI GUIDANCE FOR NEEDLE PLACE", "code_information": [{"code": "77021", "type": "CPT"}, {"code": "103834", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 2876.0, "discounted_cash": 575.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77046 MRI BREAST UNILAT W/O CONT", "code_information": [{"code": "77046", "type": "CPT"}, {"code": "200086", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6076.0, "discounted_cash": 1215.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77047 MRI BREAST BILAT W/O CONT", "code_information": [{"code": "77047", "type": "CPT"}, {"code": "200092", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7514.0, "discounted_cash": 1502.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77048 MRI BREAST UNILAT W/O&W CONT", "code_information": [{"code": "77048", "type": "CPT"}, {"code": "200088", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 6422.0, "discounted_cash": 1284.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77049 MRI BREAST BILAT W/O&W CONT", "code_information": [{"code": "77049", "type": "CPT"}, {"code": "200094", "type": "CDM"}, {"code": "610", "type": "RC"}], "standard_charges": [{"gross_charge": 7860.0, "discounted_cash": 1572.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77053 MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE", "code_information": [{"code": "77053", "type": "CPT"}, {"code": "103844", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1034.0, "discounted_cash": 206.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77054 MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE", "code_information": [{"code": "77054", "type": "CPT"}, {"code": "103846", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1034.0, "discounted_cash": 206.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77061 DX UNILAT DGTL BREAST TOMOSYNTHESIS", "code_information": [{"code": "77061", "type": "CPT"}, {"code": "182499", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 63.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77062 DX BILAT DGTL BREAST TOMOSYNTHESIS", "code_information": [{"code": "77062", "type": "CPT"}, {"code": "182503", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 318.0, "discounted_cash": 63.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77063 SCRN BILAT DGTL BREAST TOMOSYNTHESIS", "code_information": [{"code": "77063", "type": "CPT"}, {"code": "182507", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 132.0, "discounted_cash": 26.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77063 SCRN UNILAT LEFT DGTL BREAST TOMOSYNTHESIS", "code_information": [{"code": "77063", "type": "CPT"}, {"code": "184423", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 132.0, "discounted_cash": 26.4, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "52|LT"}, {"description": "HC 77063 SCRN UNILAT RIGHT DGTL BREAST TOMOSYNTHESIS", "code_information": [{"code": "77063", "type": "CPT"}, {"code": "184427", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 132.0, "discounted_cash": 26.4, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "52|RT"}, {"description": "HC 77065 DX UNILATERAL MG INCL CAD", "code_information": [{"code": "77065", "type": "CPT"}, {"code": "182631", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 722.0, "discounted_cash": 144.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77066 DX BILATERAL MG INCL CAD", "code_information": [{"code": "77066", "type": "CPT"}, {"code": "182623", "type": "CDM"}, {"code": "401", "type": "RC"}], "standard_charges": [{"gross_charge": 900.0, "discounted_cash": 180.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77067 SCRN BILATERAL MG INCL CAD", "code_information": [{"code": "77067", "type": "CPT"}, {"code": "182591", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 778.0, "discounted_cash": 155.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77067 SCRN BILATERAL MG W/IMPLT INCL CAD", "code_information": [{"code": "77067", "type": "CPT"}, {"code": "182595", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 778.0, "discounted_cash": 155.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77067 SCRN UNILAT LEFT MG INCL CAD", "code_information": [{"code": "77067", "type": "CPT"}, {"code": "184403", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 778.0, "discounted_cash": 155.6, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "52|LT"}, {"description": "HC 77067 SCRN UNILAT RIGHT MG INCL CAD", "code_information": [{"code": "77067", "type": "CPT"}, {"code": "184419", "type": "CDM"}, {"code": "403", "type": "RC"}], "standard_charges": [{"gross_charge": 778.0, "discounted_cash": 155.6, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "52|RT"}, {"description": "HC 77071 DX- STRESS OF JOINT BY PHYSICIAN", "code_information": [{"code": "77071", "type": "CPT"}, {"code": "103854", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 637.0, "discounted_cash": 127.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77072 DX- BONE AGE COMPARISON", "code_information": [{"code": "77072", "type": "CPT"}, {"code": "103856", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 787.0, "discounted_cash": 157.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77073 DX- BONE LENGTH STUDY", "code_information": [{"code": "77073", "type": "CPT"}, {"code": "103858", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1116.0, "discounted_cash": 223.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77074 DX- BONE/OSSEOUS SURVEY METAST", "code_information": [{"code": "77074", "type": "CPT"}, {"code": "103860", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": 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"billing_class": "facility"}]}, {"description": "HC 77295 ADV:SET RADIATION THER FLD 3D", "code_information": [{"code": "77295", "type": "CPT"}, {"code": "163493", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 8265.0, "discounted_cash": 1653.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77295 COM:SET RADIATION THER FLD 3D", "code_information": [{"code": "77295", "type": "CPT"}, {"code": "163495", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 9920.0, "discounted_cash": 1984.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77295 SET RADIATION THER FLD 3D", "code_information": [{"code": "77295", "type": "CPT"}, {"code": "103874", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 7000.0, "discounted_cash": 1400.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77300 DOSIMETRY CALC, EA ARC", "code_information": [{"code": "77300", "type": "CPT"}, {"code": "103876", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 955.0, "discounted_cash": 191.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77300 DOSIMETRY CALCULATION", "code_information": [{"code": "77300", "type": "CPT"}, {"code": "210784", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 851.0, "discounted_cash": 170.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77301 IMRT PLAN", "code_information": [{"code": "77301", "type": "CPT"}, {"code": "210786", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 8857.0, "discounted_cash": 1771.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77332 TX DEV DESIGN&CONSTJ SMPL", "code_information": [{"code": "77332", "type": "CPT"}, {"code": "152949", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 1764.0, "discounted_cash": 352.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77332 TX DEV DESIGN&CONSTJ SMPL (59)", "code_information": [{"code": "77332", "type": "CPT"}, {"code": "202783", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 1764.0, "discounted_cash": 352.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77334 TX DEV DESIGN&CONSTJ CPLX", "code_information": [{"code": "77334", "type": "CPT"}, {"code": "103878", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 1764.0, "discounted_cash": 352.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77334 TX DEV DESIGN&CONSTJ CPLX (59)", "code_information": [{"code": "77334", "type": "CPT"}, {"code": "202785", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 1764.0, "discounted_cash": 352.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77336 CONT MEDICAL PHYSICS CONSLTJ PER WK", "code_information": [{"code": "77336", "type": "CPT"}, {"code": "103880", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 782.0, "discounted_cash": 156.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77338 DEVICE, MLC, FOR IMRT", "code_information": [{"code": "77338", "type": "CPT"}, {"code": "210782", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 1575.0, "discounted_cash": 315.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77370 SPEC MEDICAL RADJ PHYSICS CONSLTJ", "code_information": [{"code": "77370", "type": "CPT"}, {"code": "103882", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 955.0, "discounted_cash": 191.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77372 ADV:LNR-SRS CRANIAL LES(S)1SESS,CMPL", "code_information": [{"code": "77372", "type": "CPT"}, {"code": "304642", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 46740.0, "discounted_cash": 9348.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77372 COM:LNR-SRS CRANIAL LES(S)1SESS,CMPL", "code_information": [{"code": "77372", "type": "CPT"}, {"code": "304644", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 56084.0, "discounted_cash": 11216.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77372 LNR-SRS CRANIAL LES(S)1SESS,CMPL", "code_information": [{"code": "77372", "type": "CPT"}, {"code": "304640", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 37390.0, "discounted_cash": 7478.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77373 ADV:SBRT =>1LES(S)PER FRACTX,=<5 FRACTX", "code_information": [{"code": "77373", "type": "CPT"}, {"code": "304648", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 34147.0, "discounted_cash": 6829.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77373 COM:SBRT =>1LES(S)PER FRACTX,=<5 FRACTX", "code_information": [{"code": "77373", "type": "CPT"}, {"code": "304650", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 40975.0, "discounted_cash": 8195.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77373 SBRT =>1LES(S)PER FRACTX,=<5 FRACTX", "code_information": [{"code": "77373", "type": "CPT"}, {"code": "304646", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 27318.0, "discounted_cash": 5463.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77470 SPECIAL TREATMENT PROCEDURE", "code_information": [{"code": "77470", "type": "CPT"}, {"code": "103884", "type": "CDM"}, {"code": "333", "type": "RC"}], "standard_charges": [{"gross_charge": 2831.0, "discounted_cash": 566.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 77790 SUPVJ HANDLING LOADING RADJ SRC", "code_information": [{"code": "77790", "type": "CPT"}, {"code": "301528", "type": "CDM"}, {"code": "330", "type": "RC"}], "standard_charges": [{"gross_charge": 884.0, "discounted_cash": 176.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78012 THYROID UPTAKE, SGL/MULT QNT MSRMT/S", "code_information": [{"code": "78012", "type": "CPT"}, {"code": "273809", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1211.0, "discounted_cash": 242.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78013 THYROID IMG (INCL VASC FLOW)", "code_information": [{"code": "78013", "type": "CPT"}, {"code": "273813", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1769.0, "discounted_cash": 353.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78014 THYR IMG W VF, SGL/MULT UPTK/S QNT MSRMT/S", "code_information": [{"code": "78014", "type": "CPT"}, {"code": "273817", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3007.0, "discounted_cash": 601.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78018 THYROID CARCINOMA W B IMAGING", "code_information": [{"code": "78018", "type": "CPT"}, {"code": "103894", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2938.0, "discounted_cash": 587.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78070 PARATHYROID SCAN", "code_information": [{"code": "78070", "type": "CPT"}, {"code": "103896", "type": "CDM"}, {"code": "341", "type": "RC"}], 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"discounted_cash": 228.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78103 BONE MARROW IMAGING; MULTIPLE AREAS", "code_information": [{"code": "78103", "type": "CPT"}, {"code": "185277", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1142.0, "discounted_cash": 228.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78104 BONE MARROW IMAGING; WHOLE BODY", "code_information": [{"code": "78104", "type": "CPT"}, {"code": "185281", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1142.0, "discounted_cash": 228.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78195 LYMPHATICS/LYMP GLANDS IMAGING", "code_information": [{"code": "78195", "type": "CPT"}, {"code": "103902", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2758.0, "discounted_cash": 551.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78201 LIVER IMAGING; STATIC ONLY", "code_information": [{"code": "78201", "type": "CPT"}, {"code": "301530", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1968.0, "discounted_cash": 393.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78215 LIVER SPLEEN IMAGING STATIC ONLY", "code_information": [{"code": "78215", "type": "CPT"}, {"code": "103910", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2310.0, "discounted_cash": 462.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78226 HEPATBL DUCTAL SYS IMG GLBLDR", "code_information": [{"code": "78226", "type": "CPT"}, {"code": "103912", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2466.0, "discounted_cash": 493.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78227 HEPATOBILLIA DUCT IMG W/PI", "code_information": [{"code": "78227", "type": "CPT"}, {"code": "152951", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2937.0, "discounted_cash": 587.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78231 SALIVARY GLAND/SERIAL IMAGING", "code_information": [{"code": "78231", "type": "CPT"}, {"code": "103914", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2253.0, "discounted_cash": 450.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78262 GASTRIC REFLUX STUDY", "code_information": [{"code": "78262", "type": "CPT"}, {"code": "103916", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1655.0, "discounted_cash": 331.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78264 GASTRIC EMPTYING IMG STUDY", "code_information": [{"code": "78264", "type": "CPT"}, {"code": "103918", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2452.0, "discounted_cash": 490.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78267 UREA BRTH TST C-14 ISOTOPIC ACQUISJ ALYS", "code_information": [{"code": "78267", "type": "CPT"}, {"code": "103920", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 721.0, "discounted_cash": 144.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78278 G.I. BLEEDER SCAN", "code_information": [{"code": "78278", "type": "CPT"}, {"code": "103928", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2577.0, "discounted_cash": 515.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78290 MECKELS DIVERTICULUM STUDY", "code_information": [{"code": "78290", "type": "CPT"}, {"code": "103930", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2109.0, "discounted_cash": 421.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78300 BONE AND/OR JOINT IMAGING, LIMITED", "code_information": [{"code": "78300", "type": "CPT"}, {"code": "103932", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1456.0, "discounted_cash": 291.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78305 BONE AND/OR JOINT IMAGING, MULTIPLE AREAS", "code_information": [{"code": "78305", "type": "CPT"}, {"code": "103934", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2237.0, "discounted_cash": 447.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78306 BONE AND/OR JOINT IMAGING, WHOLE BODY", "code_information": [{"code": "78306", "type": "CPT"}, {"code": "103936", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2973.0, "discounted_cash": 594.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78315 BONE AND/OR JOINT IMAGING, 3 PHASE", "code_information": [{"code": "78315", "type": "CPT"}, {"code": "103938", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 6095.0, "discounted_cash": 1219.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78445 NON-CARDIAC VASCULAR FLOW STUD", "code_information": [{"code": "78445", "type": "CPT"}, {"code": "103942", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1877.0, "discounted_cash": 375.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78451 MYOCAR PERF IMG TOMO SNGL (SPECT)", "code_information": [{"code": "78451", "type": "CPT"}, {"code": "103944", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": [{"gross_charge": 5736.0, "discounted_cash": 1147.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78452 MYOCAR PERF IMG TOMO MULTI (SPECT)", "code_information": [{"code": "78452", "type": "CPT"}, {"code": "103946", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 7605.0, "discounted_cash": 1521.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78458 VENOGRAM, BILATERAL", "code_information": [{"code": "78458", "type": "CPT"}, {"code": "103952", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1601.0, "discounted_cash": 320.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78466 MYOCARDIAL IMAGING-M.I. PLANAR", "code_information": [{"code": "78466", "type": "CPT"}, {"code": "103956", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": [{"gross_charge": 1578.0, "discounted_cash": 315.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78472 CARDIAC BLOOD POOL / REST", "code_information": [{"code": "78472", "type": "CPT"}, {"code": "103960", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2821.0, "discounted_cash": 564.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78473 CARDIAC BLOOD POOL W/STRESS", "code_information": [{"code": "78473", "type": "CPT"}, {"code": "103962", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3584.0, "discounted_cash": 716.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78481 FIRST PASS STUDY-CARD-BL-POOL", "code_information": [{"code": "78481", "type": "CPT"}, {"code": "103964", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": [{"gross_charge": 1995.0, "discounted_cash": 399.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78491 MYOCARD PET SNGL STDY", "code_information": [{"code": "78491", "type": "CPT"}, {"code": "103966", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 9435.0, "discounted_cash": 1887.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78492 MYOCARD PET MULTI STDY", "code_information": [{"code": "78492", "type": "CPT"}, {"code": "103968", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 9435.0, "discounted_cash": 1887.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78494 CARDIAC BLOOD POOL-SPECT", "code_information": [{"code": "78494", "type": "CPT"}, {"code": "103970", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": 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"billing_class": "facility"}]}, {"description": "HC 78605 BRAIN SCAN", "code_information": [{"code": "78605", "type": "CPT"}, {"code": "103988", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3216.0, "discounted_cash": 643.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78608 PET/CT BRAIN", "code_information": [{"code": "78608", "type": "CPT"}, {"code": "103992", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 7362.0, "discounted_cash": 1472.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78608 PET/CT BRAIN, SUBSQ(PS)", "code_information": [{"code": "78608", "type": "CPT"}, {"code": "202771", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 7362.0, "discounted_cash": 1472.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78630 CISTERNOGRAM", "code_information": [{"code": "78630", "type": "CPT"}, {"code": "103994", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3187.0, "discounted_cash": 637.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78645 SHUNTAGRAM", "code_information": [{"code": "78645", "type": "CPT"}, {"code": "103996", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1995.0, "discounted_cash": 399.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78650 CSF LEAKAGE DETECTION STUDY", "code_information": [{"code": "78650", "type": "CPT"}, {"code": "103998", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3389.0, "discounted_cash": 677.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78700 NM-DMSA RENAL", "code_information": [{"code": "78700", "type": "CPT"}, {"code": "104000", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": 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"billing_class": "facility"}]}, {"description": "HC 78761 TESTICULAR SCAN", "code_information": [{"code": "78761", "type": "CPT"}, {"code": "104010", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 3046.0, "discounted_cash": 609.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78800 RP LOCLZJ TUM PLNR 1 AREA 1 DAY IMAGING", "code_information": [{"code": "78800", "type": "CPT"}, {"code": "209167", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 1066.0, "discounted_cash": 213.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78801 RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D", "code_information": [{"code": "78801", "type": "CPT"}, {"code": "104012", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 2344.0, "discounted_cash": 468.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78802 RP LOCLZJ TUM PLNR WHOLE BODY 1 DAY IMAGING", "code_information": [{"code": "78802", "type": "CPT"}, {"code": "104014", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": [{"gross_charge": 3553.0, "discounted_cash": 710.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78803 RP LOCLZJ TUM SPECT 1 AREA SNGL DAY IMAGING", "code_information": [{"code": "78803", "type": "CPT"}, {"code": "214839", "type": "CDM"}, {"code": "341", "type": "RC"}], "standard_charges": [{"gross_charge": 4114.0, "discounted_cash": 822.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78804 RP LOCLZJ TUM/DSTRBJ AGT WHBDY REQ 2/> DAY IMG", "code_information": [{"code": "78804", "type": "CPT"}, {"code": "104018", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": [{"gross_charge": 3607.0, "discounted_cash": 721.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78814 PET IMAGE W/CT LMTD", "code_information": [{"code": "78814", "type": "CPT"}, {"code": "176340", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 11227.0, "discounted_cash": 2245.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78815 PET SKULL BASE-MID THIGH", "code_information": [{"code": "78815", "type": "CPT"}, {"code": "104024", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 11628.0, "discounted_cash": 2325.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78815 PET SKULL BASE-MID THIGH,SUBSEQ(PS)", "code_information": [{"code": "78815", "type": "CPT"}, {"code": "202773", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 11628.0, "discounted_cash": 2325.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78816 PET WHOLE BODY", "code_information": [{"code": "78816", "type": "CPT"}, {"code": "104026", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 12814.0, "discounted_cash": 2562.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78816 PET WHOLE BODY, SUBSEQ(PS)", "code_information": [{"code": "78816", "type": "CPT"}, {"code": "202775", "type": "CDM"}, {"code": "404", "type": "RC"}], "standard_charges": [{"gross_charge": 12814.0, "discounted_cash": 2562.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78830 RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING", "code_information": [{"code": "78830", "type": "CPT"}, {"code": "214891", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": [{"gross_charge": 4915.0, "discounted_cash": 983.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78831 RP LOCLZJ TUM SPECT 2 AREA 1D IMG/1 AREA IMG>2+D", "code_information": [{"code": "78831", "type": "CPT"}, {"code": "214893", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": [{"gross_charge": 4026.0, "discounted_cash": 805.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 78832 RP LOCLZJ TUM SPECT CT 2AREA 1D IMG/1 AR IMG>2+D", "code_information": [{"code": "78832", "type": "CPT"}, {"code": "214895", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": [{"gross_charge": 4566.0, "discounted_cash": 913.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 79005 RP THER ORAL ADMN", "code_information": [{"code": "79005", "type": "CPT"}, {"code": "104030", "type": "CDM"}, {"code": "342", "type": "RC"}], "standard_charges": [{"gross_charge": 868.0, "discounted_cash": 173.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 79300 SM-153 THERAPY", "code_information": [{"code": "79300", "type": "CPT"}, {"code": "104036", "type": "CDM"}, {"code": "340", "type": "RC"}], "standard_charges": [{"gross_charge": 816.0, "discounted_cash": 163.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 79445 RADIOPHARM INTRA ART PARTICULA", "code_information": [{"code": "79445", "type": "CPT"}, {"code": "104038", "type": "CDM"}, {"code": "320", "type": "RC"}], "standard_charges": [{"gross_charge": 1646.0, "discounted_cash": 329.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80047 METABOLIC PANEL IONIZED CA", "code_information": [{"code": "80047", "type": "CPT"}, {"code": "104074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 378.0, "discounted_cash": 75.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80048 METABOLIC PANEL TOTAL CA", "code_information": [{"code": "80048", "type": "CPT"}, {"code": "104076", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 19.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80050 GENERAL HEALTH PANEL", "code_information": [{"code": "80050", "type": "CPT"}, {"code": "104078", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 441.0, "discounted_cash": 88.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80051 ELECTROLYTE PANEL", "code_information": [{"code": "80051", "type": "CPT"}, {"code": "104080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 81.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80053 COMPREHEN METABOLIC PANEL", "code_information": [{"code": "80053", "type": "CPT"}, {"code": "104082", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 454.0, "discounted_cash": 90.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80055 OBSTETRIC PANEL", "code_information": [{"code": "80055", "type": "CPT"}, {"code": "104084", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 574.0, "discounted_cash": 114.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80061 LIPID PANEL", "code_information": [{"code": "80061", "type": "CPT"}, {"code": "104086", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 64.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80069 RENAL FUNCTION PANEL", "code_information": [{"code": "80069", "type": "CPT"}, {"code": "104088", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 390.0, "discounted_cash": 78.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80074 ACUTE HEPATITIS PANEL", "code_information": [{"code": "80074", "type": "CPT"}, {"code": "104090", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 847.0, "discounted_cash": 169.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80076 HEPATIC FUNCTION PANEL", "code_information": [{"code": "80076", "type": "CPT"}, {"code": "104092", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 75.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80081 OBSTETRIC PANEL", "code_information": [{"code": "80081", "type": "CPT"}, {"code": "176505", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 397.0, "discounted_cash": 79.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80143 ACETAMINOPHEN LEVEL", "code_information": [{"code": "80143", "type": "CPT"}, {"code": "196722", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 21.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80145 ADALIMUMAB LEVEL", "code_information": [{"code": "80145", "type": "CPT"}, {"code": "196726", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 44.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80150 ASSAY OF AMIKACIN", "code_information": [{"code": "80150", "type": "CPT"}, {"code": "104098", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 595.0, "discounted_cash": 119.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80151 DRUG ASSAY AMIODARONE", "code_information": [{"code": "80151", "type": "CPT"}, {"code": "189534", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 20.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80155 CAFFINE LEVEL", "code_information": [{"code": "80155", "type": "CPT"}, {"code": "175845", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 507.0, "discounted_cash": 101.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80156 ASSAY, CARBAMAZEPINE, TOTAL", "code_information": [{"code": "80156", "type": "CPT"}, {"code": "104104", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 125.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80157 ASSAY, CARBAMAZEPINE, FREE", "code_information": [{"code": "80157", "type": "CPT"}, {"code": "104106", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 57.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80158 ASSAY OF CYCLOSPORINE", "code_information": [{"code": "80158", "type": "CPT"}, {"code": "104108", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1357.0, "discounted_cash": 271.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80159 CLOZAPINE LEVEL", "code_information": [{"code": "80159", "type": "CPT"}, {"code": "175857", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 666.0, "discounted_cash": 133.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80162 ASSAY OF DIGOXIN", "code_information": [{"code": "80162", "type": "CPT"}, {"code": "104110", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 540.0, "discounted_cash": 108.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80164 DIPROPYLACETIC ACID TOTAL", "code_information": [{"code": "80164", "type": "CPT"}, {"code": "104112", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 544.0, "discounted_cash": 108.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80164 VALPROIC ACID, TOTAL", "code_information": [{"code": "80164", "type": "CPT"}, {"code": "191096", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 19.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80165 DIPROPYLACETIC ACID FREE", "code_information": [{"code": "80165", "type": "CPT"}, {"code": "182008", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 538.0, "discounted_cash": 107.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80167 DRUG ASSAY FELBAMATE", "code_information": [{"code": "80167", "type": "CPT"}, {"code": "189536", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 20.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80168 ASSAY OF ETHOSUXIMIDE", "code_information": [{"code": "80168", "type": "CPT"}, {"code": "104116", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 665.0, "discounted_cash": 133.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80169 EVEROLIMUS", "code_information": [{"code": "80169", "type": "CPT"}, {"code": "191100", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 102.0, "discounted_cash": 20.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80170 ASSAY OF GENTAMICIN", "code_information": [{"code": "80170", "type": "CPT"}, {"code": "104118", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 633.0, "discounted_cash": 126.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80171 GABAPENTIN/NEURONTIN LEVEL", "code_information": [{"code": "80171", "type": "CPT"}, {"code": "175849", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 602.0, "discounted_cash": 120.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80175 LAMICTAL/LAMOTRIGENE LEVEL", "code_information": [{"code": "80175", "type": "CPT"}, {"code": "175847", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 534.0, "discounted_cash": 106.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80176 ASSAY OF LIDOCAINE", "code_information": [{"code": "80176", "type": "CPT"}, {"code": "104122", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 700.0, "discounted_cash": 140.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80177 KEPPRA/LEVETIRACETAM LEVEL", "code_information": [{"code": "80177", "type": "CPT"}, {"code": "175851", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 522.0, "discounted_cash": 104.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80178 ASSAY OF LITHIUM", "code_information": [{"code": "80178", "type": "CPT"}, {"code": "104124", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 620.0, "discounted_cash": 124.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80179 SALICYLATE LEVEL", "code_information": [{"code": "80179", "type": "CPT"}, {"code": "196734", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 21.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80180 MYCOPHENOLIC ACID", "code_information": [{"code": "80180", "type": "CPT"}, {"code": "175859", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 808.0, "discounted_cash": 161.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80183 TRILEPTAL(HYDROXYCARBAZEPINE)", "code_information": [{"code": "80183", "type": "CPT"}, {"code": "175853", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 472.0, "discounted_cash": 94.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80184 ASSAY OF PHENOBARBITAL", "code_information": [{"code": "80184", "type": "CPT"}, {"code": "104128", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 604.0, "discounted_cash": 120.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80185 ASSAY OF PHENYTOIN, TOTAL", "code_information": [{"code": "80185", "type": "CPT"}, {"code": "104130", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 667.0, "discounted_cash": 133.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80186 ASSAY OF PHENYTOIN, FREE", "code_information": [{"code": "80186", "type": "CPT"}, {"code": "104132", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 816.0, "discounted_cash": 163.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80188 ASSAY OF PRIMIDONE", "code_information": [{"code": "80188", "type": "CPT"}, {"code": "104134", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 880.0, "discounted_cash": 176.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80189 DRUG ASSAY ITRACONAZOLE", "code_information": [{"code": "80189", "type": "CPT"}, {"code": "189538", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 148.0, "discounted_cash": 29.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80192 ASSAY OF PROCAINAMIDE", "code_information": [{"code": "80192", "type": "CPT"}, {"code": "104136", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 704.0, "discounted_cash": 140.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80193 LEFLUNOMIDE", "code_information": [{"code": "80193", "type": "CPT"}, {"code": "196746", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 16.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80194 ASSAY OF QUINIDINE", "code_information": [{"code": "80194", "type": "CPT"}, {"code": "104138", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 540.0, "discounted_cash": 108.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80195 ASSAY OF SIROLIMUS", "code_information": [{"code": "80195", "type": "CPT"}, {"code": "104140", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 507.0, "discounted_cash": 101.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80197 ASSAY OF TACROLIMUS", "code_information": [{"code": "80197", "type": "CPT"}, {"code": "104144", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 765.0, "discounted_cash": 153.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80198 ASSAY OF THEOPHYLLINE", "code_information": [{"code": "80198", "type": "CPT"}, {"code": "104146", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 548.0, "discounted_cash": 109.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80200 ASSAY OF TOBRAMYCIN", "code_information": [{"code": "80200", "type": "CPT"}, {"code": "104148", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 628.0, "discounted_cash": 125.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80201 ASSAY OF TOPIRAMATE", "code_information": [{"code": "80201", "type": "CPT"}, {"code": "104150", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 72.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80202 ASSAY OF VANCOMYCIN", "code_information": [{"code": "80202", "type": "CPT"}, {"code": "104152", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 641.0, "discounted_cash": 128.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80203 ZONISAMIDE(CHR QUANT,SNGL ANALYTE)", "code_information": [{"code": "80203", "type": "CPT"}, {"code": "175855", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 715.0, "discounted_cash": 143.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80204 METHOTREXATE LEVEL", "code_information": [{"code": "80204", "type": "CPT"}, {"code": "196766", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 44.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80210 RUFINAMIDE", "code_information": [{"code": "80210", "type": "CPT"}, {"code": "196770", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 31.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80220 DRUG ASY HYDROXYCHLOROQUINE", "code_information": [{"code": "80220", "type": "CPT"}, {"code": "292596", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 52.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80230 DRUG ASSAY INFLIXIMAB", "code_information": [{"code": "80230", "type": "CPT"}, {"code": "227282", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 54.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80230 INFLIXIMAB ACTIVITY", "code_information": [{"code": "80230", "type": "CPT"}, {"code": "196774", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 54.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80235 LACOSAMIDE VIMPAT", "code_information": [{"code": "80235", "type": "CPT"}, {"code": "196778", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 31.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80280 DRUG ASSAY VEDOLIZUMAB", "code_information": [{"code": "80280", "type": "CPT"}, {"code": "196782", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 44.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80285 DRUG ASSAY VORICONAZOLE", "code_information": [{"code": "80285", "type": "CPT"}, {"code": "179479", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 31.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80299 DESMETHYLCLOMIPAMINE", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "196806", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 127.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80299 DEXAMETHASONE, SERUM OR PLASMA ARUP", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "263113", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 127.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80299 QUANTITATIVE ASSAY, DRUG", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "104154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 127.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80299 THERAPEUTIC DRUG ASSAY", "code_information": [{"code": "80299", "type": "CPT"}, {"code": "196826", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 127.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80305 DRUG SCRN DIRECT OBSERVATION", "code_information": [{"code": "80305", "type": "CPT"}, {"code": "196842", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 43.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80305 DRUG TST PRSMV QUAL DIR OPTICAL OBS, URINE", "code_information": [{"code": "80305", "type": "CPT"}, {"code": "175967", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 558.0, "discounted_cash": 111.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80307 ADENOSINE DEAMINASE BF", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "196858", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 66.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80307 DRUG SCREEN IMMUNOASSAY", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "196874", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 131.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80307 DRUG TST PRSMV CHEM ANLZR ABUSE PANEL I, URINE", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "186584", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 323.0, "discounted_cash": 64.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80307 DRUG TST PRSMV CHEM ANLZR ABUSE PANEL II, URINE", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "186581", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 66.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80307 DRUG TST PRSMV CHEM ANLZR BENZODIAZEPINES, URINE", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "186571", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 66.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80307 DRUG TST PRSMV CHEM ANLZR CANNABINOIDS, URINE", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "186590", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 66.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80307 DRUG TST PRSMV CHEM ANLZR MECONIUM", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "186569", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 56.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80307 DRUG TST PRSMV CHEM ANLZR OPIATES, URINE", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "186586", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 66.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80307 DRUG TST PRSMV CHEM ANLZR QUALITATE/MULTI", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "186561", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 331.0, "discounted_cash": 66.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80307 DRUG TST PRSMV CHEM ANLZR SINGLE", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "186563", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 656.0, "discounted_cash": 131.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80307 DRUGS OF ABUSE SCREEN", "code_information": [{"code": "80307", "type": "CPT"}, {"code": "217205", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 66.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80320 ASSAY OF ETHANOL", "code_information": [{"code": "80320", "type": "CPT"}, {"code": "104194", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 559.0, "discounted_cash": 111.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80321 ALCOHOLS BIOMARKERS 1OR 2", "code_information": [{"code": "80321", "type": "CPT"}, {"code": "238661", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 1095.0, "discounted_cash": 219.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80323 ASSAY OF NICOTINE", "code_information": [{"code": "80323", "type": "CPT"}, {"code": "104544", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 486.0, "discounted_cash": 97.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80324 AMPHETAMINE CONFIRMATION,URINE", "code_information": [{"code": "80324", "type": "CPT"}, {"code": "166080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 598.0, "discounted_cash": 119.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80325 AMPHETAMINES 3OR 4", "code_information": [{"code": "80325", "type": "CPT"}, {"code": "238663", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 86.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80326 AMPHETAMINES 5 OR MORE", "code_information": [{"code": "80326", "type": "CPT"}, {"code": "212352", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 437.0, "discounted_cash": 87.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80327 DIHYDROTESTOSTERONE REF 1", "code_information": [{"code": "80327", "type": "CPT"}, {"code": "295998", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 715.0, "discounted_cash": 143.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80329 DRUG SCR ANALGESICS NON-OPIOID 1 OR 2", "code_information": [{"code": "80329", "type": "CPT"}, {"code": "176379", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 134.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80330 DRUG SCR ANALGESICS NON-OPIOID 3-5", "code_information": [{"code": "80330", "type": "CPT"}, {"code": "176381", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 134.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80331 DRUG SCR ANALGESICS NON-OPIOID 6 OR MORE", "code_information": [{"code": "80331", "type": "CPT"}, {"code": "176383", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 674.0, "discounted_cash": 134.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80334 ANTIDEPRESS SEROTONERGIC 6 OR MORE", "code_information": [{"code": "80334", "type": "CPT"}, {"code": "277419", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80335 ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 1 OR 2", "code_information": [{"code": "80335", "type": "CPT"}, {"code": "176373", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 965.0, "discounted_cash": 193.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80336 ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 3-5", "code_information": [{"code": "80336", "type": "CPT"}, {"code": "176375", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 965.0, "discounted_cash": 193.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80337 ANTIDEPRESSANTS TRICYCLIC OTHER CYCLICALS 6/MORE", "code_information": [{"code": "80337", "type": "CPT"}, {"code": "176377", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 965.0, "discounted_cash": 193.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80339 FELBAMATE", "code_information": [{"code": "80339", "type": "CPT"}, {"code": "212354", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 459.0, "discounted_cash": 91.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80341 ANTIEPILEPTICS NOS 7 OR MORE", "code_information": [{"code": "80341", "type": "CPT"}, {"code": "277421", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80344 ANTIPSYCHOTICS NOS 7 OR MORE", "code_information": [{"code": "80344", "type": "CPT"}, {"code": "277423", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80345 BARBITURATE CONFIRMATION,URINE", "code_information": [{"code": "80345", "type": "CPT"}, {"code": "163744", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 236.0, "discounted_cash": 47.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80346 ASSAY OF BENZODIAZEPINES", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "104102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 885.0, "discounted_cash": 177.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80346 BENZODIAZEPINE CONFIRMATION,UR", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "163664", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 534.0, "discounted_cash": 106.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80346 CLONOPIN BLOOD LEVEL", "code_information": [{"code": "80346", "type": "CPT"}, {"code": "163662", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 982.0, "discounted_cash": 196.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80347 DRGS BENZ CONFIRM; 13 OR MORE", "code_information": [{"code": "80347", "type": "CPT"}, {"code": "212356", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 437.0, "discounted_cash": 87.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80348 BUPRENORPHINE CONFIRM", "code_information": [{"code": "80348", "type": "CPT"}, {"code": "212358", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 86.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80349 CANNABINOIDS NATURAL", "code_information": [{"code": "80349", "type": "CPT"}, {"code": "212360", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 86.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80353 ASSAY OF COCAINE", "code_information": [{"code": "80353", "type": "CPT"}, {"code": "104310", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80353 COCAINE OR METABOLITE", "code_information": [{"code": "80353", "type": "CPT"}, {"code": "191104", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80354 FENTANYL/NORFENTANYL,URINE", "code_information": [{"code": "80354", "type": "CPT"}, {"code": "163884", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 347.0, "discounted_cash": 69.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80355 DRUG SCREENING COCAINE", "code_information": [{"code": "80355", "type": "CPT"}, {"code": "258245", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 437.0, "discounted_cash": 87.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80355 DRUG SCREENING GABAPENTIN NON-BLOOD", "code_information": [{"code": "80355", "type": "CPT"}, {"code": "191115", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 437.0, "discounted_cash": 87.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80356 SCREEN HEROIN METABOLITE", "code_information": [{"code": "80356", "type": "CPT"}, {"code": "277425", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80357 SCREEN KETAMINE AND NORKETAMINE", "code_information": [{"code": "80357", "type": "CPT"}, {"code": "277427", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80358 ASSAY OF METHADONE", "code_information": [{"code": "80358", "type": "CPT"}, {"code": "104532", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80359 METHYLENEDIOXYAMPHETAMINES", "code_information": [{"code": "80359", "type": "CPT"}, {"code": "225721", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 202.0, "discounted_cash": 40.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80360 METHYLPHENIDATE AND MET URN QUANT", "code_information": [{"code": "80360", "type": "CPT"}, {"code": "283827", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80361 OPIATE CONFIRMATION,URINE", "code_information": [{"code": "80361", "type": "CPT"}, {"code": "163888", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80362 MEPERIDINE CONFIRM UR", "code_information": [{"code": "80362", "type": "CPT"}, {"code": "212362", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 205.0, "discounted_cash": 41.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80363 OPIODS AND OPIATE ANALOGS 3 OR 4", "code_information": [{"code": "80363", "type": "CPT"}, {"code": "277429", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80364 OPIOID &OPIATE ANALOG 5/MORE", "code_information": [{"code": "80364", "type": "CPT"}, {"code": "238671", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 459.0, "discounted_cash": 91.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80365 OPIATES", "code_information": [{"code": "80365", "type": "CPT"}, {"code": "163882", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 430.0, "discounted_cash": 86.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80365 OXYCODONE, BLOOD", "code_information": [{"code": "80365", "type": "CPT"}, {"code": "163886", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 430.0, "discounted_cash": 86.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80366 SCREEN PREGABALIN LEVEL", "code_information": [{"code": "80366", "type": "CPT"}, {"code": "277431", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80367 DARVON BLOOD", "code_information": [{"code": "80367", "type": "CPT"}, {"code": "163880", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80368 SEDATIVE HYPNOTICS", "code_information": [{"code": "80368", "type": "CPT"}, {"code": "238673", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 169.0, "discounted_cash": 33.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80370 SCREEN MUSCLE RELAXANTS 3 OR MORE", "code_information": [{"code": "80370", "type": "CPT"}, {"code": "277433", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80371 SCREEN SYNTHETIC STIMULANTS", "code_information": [{"code": "80371", "type": "CPT"}, {"code": "277435", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80372 SCREEN TAPENTADOL", "code_information": [{"code": "80372", "type": "CPT"}, {"code": "277437", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80373 TRAMADOL", "code_information": [{"code": "80373", "type": "CPT"}, {"code": "202084", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 45.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80375 DEXAMETHASONE", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "229284", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 63.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80375 WARFARIN QUANTITATIVE ARUP", "code_information": [{"code": "80375", "type": "CPT"}, {"code": "263109", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 16.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 80377 SULFONYLUREA SCREEN QUANT, URINE", "code_information": [{"code": "80377", "type": "CPT"}, {"code": "209228", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 80.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81000 URINALYSIS, NONAUTO W/SCOPE", "code_information": [{"code": "81000", "type": "CPT"}, {"code": "104158", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 31.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81001 URINALYSIS, AUTO W/SCOPE", 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67.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81401 APOLIPOPROTEIN E GENOTYPING, BLOOD", "code_information": [{"code": "81401", "type": "CPT"}, {"code": "191138", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 1542.0, "discounted_cash": 308.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81403 MOLECULAR PATH, LEVEL 4", "code_information": [{"code": "81403", "type": "CPT"}, {"code": "298457", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 588.0, "discounted_cash": 117.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81404 BETA GLOBIN GENE SEQUENCE", "code_information": [{"code": "81404", "type": "CPT"}, {"code": "198594", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1455.0, "discounted_cash": 291.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81405 MOL PATH PROCEDURE LEVEL 6", "code_information": [{"code": "81405", "type": "CPT"}, {"code": "198610", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1595.0, "discounted_cash": 319.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81408 MOL PATH PROCEDURE LEVEL 9", "code_information": [{"code": "81408", "type": "CPT"}, {"code": "198626", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 10584.0, "discounted_cash": 2116.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81450 ONCOHEME NGS FOR HEMATOLOGIC CANCER", "code_information": [{"code": "81450", "type": "CPT"}, {"code": "191152", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 4869.0, "discounted_cash": 973.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81479 MOL PATH PROCEDURE UNLISTED", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "198664", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 344.0, "discounted_cash": 68.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81479 MOLECULAR PHENOTYPING", "code_information": [{"code": "81479", "type": "CPT"}, {"code": "177353", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 344.0, "discounted_cash": 68.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81510 MATERNAL SCRN, 3 ANALYTES", "code_information": [{"code": "81510", "type": "CPT"}, {"code": "298459", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 316.0, "discounted_cash": 63.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81511 MATERNAL SCRN, 4 ANALYTES", "code_information": [{"code": "81511", "type": "CPT"}, {"code": "298461", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 81.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81515 NFCT DS BV&VAGINITIS RTPCR AMP", "code_information": [{"code": "81515", "type": "CPT"}, {"code": "318268", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 1100.0, "discounted_cash": 220.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81517 ENHANCED LIVER FIBROSIS (ELF) SCORE", "code_information": [{"code": "81517", "type": "CPT"}, {"code": "314661", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 562.0, "discounted_cash": 112.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 81596 INFCT DZ CHR HCV 6 BIOCHEM ASSAY SMF ALG LVR", "code_information": [{"code": "81596", "type": "CPT"}, {"code": "202598", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 636.0, "discounted_cash": 127.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82009 TEST FOR ACETONE/KETONES", "code_information": [{"code": "82009", "type": "CPT"}, {"code": "104176", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 22.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82010 ACETONE OR OTHER KETONE BODIES, SERUM; QUANTITATIVE", "code_information": [{"code": "82010", "type": "CPT"}, {"code": "191158", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 55.0, "discounted_cash": 11.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82016 NBS FATTY ACIDS QUALITATIVE", "code_information": [{"code": "82016", "type": "CPT"}, {"code": "196953", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 19.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82017 ACYLCARNITINE QNT PROF PLASMA", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "196957", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 545.0, "discounted_cash": 109.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82017 ACYLCARNITINES, QUANT", "code_information": [{"code": "82017", "type": "CPT"}, {"code": "104180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 545.0, "discounted_cash": 109.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82024 ASSAY OF ACTH", "code_information": [{"code": "82024", "type": "CPT"}, {"code": "104182", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 743.0, "discounted_cash": 148.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82040 ALBUMIN SERUM NEPH", "code_information": [{"code": "82040", "type": "CPT"}, {"code": "196959", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 25.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82040 ALBUMIN SERUM NEPH REF LAB", "code_information": [{"code": "82040", "type": "CPT"}, {"code": "196961", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 25.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82040 ASSAY SERUM ALBUMIN PLASM/WHOLE BLOOD", "code_information": [{"code": "82040", "type": "CPT"}, {"code": "104186", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 25.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82042 ALBUMIN, QUANT OTHER SOURCE", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "163714", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82042 ASSAY OF URINE ALBUMIN", "code_information": [{"code": "82042", "type": "CPT"}, {"code": "104188", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 8.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82043 MICROALBUMIN, QUANTITATIVE", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "104190", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 399.0, "discounted_cash": 79.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82043 MICROALBUMIN, UR 24HR", "code_information": [{"code": "82043", "type": "CPT"}, {"code": "163716", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 410.0, "discounted_cash": 82.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82077 ETHANOL SERUM", "code_information": [{"code": "82077", "type": "CPT"}, {"code": "196963", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 96.0, "discounted_cash": 19.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82085 ASSAY OF ALDOLASE", "code_information": [{"code": "82085", "type": "CPT"}, {"code": "104198", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 268.0, "discounted_cash": 53.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82088 ALDOSTERONE, 24 HR URINE", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "163718", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 794.0, "discounted_cash": 158.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82088 ASSAY OF ALDOSTERONE", "code_information": [{"code": "82088", "type": "CPT"}, {"code": "104200", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 710.0, "discounted_cash": 142.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82103 ALPHA 1 ANTITRYPSIN FECES", "code_information": [{"code": "82103", "type": "CPT"}, {"code": "196965", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 68.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82103 ALPHA-1-ANTITRYPSIN, TOTAL", "code_information": [{"code": "82103", "type": "CPT"}, {"code": "104202", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 68.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82104 ALPHA-1-ANTITRYP PHENO", "code_information": [{"code": "82104", "type": "CPT"}, {"code": "212364", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 72.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82104 ALPHA-1-ANTITRYPSIN PHENOTYPE", "code_information": [{"code": "82104", "type": "CPT"}, {"code": "219896", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 360.0, "discounted_cash": 72.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82105 AFP (TRI TEST)", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "163720", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 165.0, "discounted_cash": 33.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82105 AFP, TUMOR MARKER", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "163722", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 383.0, "discounted_cash": 76.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82105 ALPHA-FETOPROTEIN, SERUM", "code_information": [{"code": "82105", "type": "CPT"}, {"code": "104204", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 423.0, "discounted_cash": 84.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82107 ALPHA FETOPROT TOT L3", "code_information": [{"code": "82107", "type": "CPT"}, {"code": "212366", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 71.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82128 AMINO ACID SCREEN, PLASMA", "code_information": [{"code": "82128", "type": "CPT"}, {"code": "163726", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 75.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82128 NBS AMINO ACIDS QUALITIATIVE", "code_information": [{"code": "82128", "type": "CPT"}, {"code": "196967", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 362.0, "discounted_cash": 72.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82135 ASSAY, AMINOLEVULINIC ACID", "code_information": [{"code": "82135", "type": "CPT"}, {"code": "104210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 433.0, "discounted_cash": 86.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82139 AMINO ACID FRACT. PLASMA", "code_information": [{"code": "82139", "type": "CPT"}, {"code": "163734", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1936.0, "discounted_cash": 387.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82139 AMINO ACIDS QUAN 6 OR MORE BLD", "code_information": [{"code": "82139", "type": "CPT"}, {"code": "196975", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 1936.0, "discounted_cash": 387.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82139 AMINO ACIDS, QUAN, 6 OR MORE", "code_information": [{"code": "82139", "type": "CPT"}, {"code": "104212", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1936.0, "discounted_cash": 387.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82140 ASSAY OF AMMONIA", "code_information": [{"code": "82140", "type": "CPT"}, {"code": "104214", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 53.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82150 AMYLASE URINE", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "163736", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 35.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82150 AMYLASE, BODY FLUID", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "163738", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 228.0, "discounted_cash": 45.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82150 ASSAY OF AMYLASE", "code_information": [{"code": "82150", "type": "CPT"}, {"code": "104220", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 179.0, "discounted_cash": 35.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82157 ASSAY OF ANDROSTENEDIONE", "code_information": [{"code": "82157", "type": "CPT"}, {"code": "104222", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 696.0, "discounted_cash": 139.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82163 ASSAY OF ANGIOTENSIN II", "code_information": [{"code": "82163", "type": "CPT"}, {"code": "190144", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 22.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82164 ACE CSF", "code_information": [{"code": "82164", "type": "CPT"}, {"code": "196983", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 75.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82164 ANGIOTENSIN I ENZYME TEST", "code_information": [{"code": "82164", "type": "CPT"}, {"code": "104224", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 75.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82166 ANTI-MULLERIAN HORMONE (AMH)", "code_information": [{"code": "82166", "type": "CPT"}, {"code": "292594", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 14.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82172 APOLIPOPROTEIN A", "code_information": [{"code": "82172", "type": "CPT"}, {"code": "196987", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82172 APOLIPOPROTEIN B", "code_information": [{"code": "82172", "type": "CPT"}, {"code": "196985", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82172 ASSAY OF APOLIPOPROTEIN", "code_information": [{"code": "82172", "type": "CPT"}, {"code": "104226", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82175 ARSENIC", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "163742", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 627.0, "discounted_cash": 125.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82175 ARSENIC URINE", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "196991", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 107.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82175 ASSAY OF ARSENIC", "code_information": [{"code": "82175", "type": "CPT"}, {"code": "104228", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 512.0, "discounted_cash": 102.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82180 ASSAY OF ASCORBIC ACID", "code_information": [{"code": "82180", "type": "CPT"}, {"code": "104230", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 65.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82232 ASSAY OF BETA-2 PROTEIN", "code_information": [{"code": "82232", "type": "CPT"}, {"code": "104234", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 520.0, "discounted_cash": 104.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82232 BETA 2 MICROGLOBULIN", "code_information": 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"outpatient", "billing_class": "facility"}]}, {"description": "HC 82261 ASSAY OF BIOTINIDASE", "code_information": [{"code": "82261", "type": "CPT"}, {"code": "238697", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 18.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82270 OCCULT BLOOD, FECES", "code_information": [{"code": "82270", "type": "CPT"}, {"code": "104246", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 25.0, "discounted_cash": 5.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82271 OCCULT BLOOD, GASTRIC", "code_information": [{"code": "82271", "type": "CPT"}, {"code": "163750", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 25.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82272 OCCULT BLD FECES, 1-3 TESTS", 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"billing_class": "facility"}]}, {"description": "HC 82308 ASSAY OF CALCITONIN", "code_information": [{"code": "82308", "type": "CPT"}, {"code": "104260", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 619.0, "discounted_cash": 123.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82310 ASSAY OF CALCIUM", "code_information": [{"code": "82310", "type": "CPT"}, {"code": "104262", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 31.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82330 ASSAY OF CALCIUM", "code_information": [{"code": "82330", "type": "CPT"}, {"code": "104264", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 417.0, "discounted_cash": 83.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82330 CALCIUM, IONIZED (I-STAT)", "code_information": 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"billing_class": "facility"}]}, {"description": "HC 82375 ASSAY, CARBOXYHB, QUANT", "code_information": [{"code": "82375", "type": "CPT"}, {"code": "104272", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 345.0, "discounted_cash": 69.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82375 CARBOXYHEMOGLOBIN", "code_information": [{"code": "82375", "type": "CPT"}, {"code": "197031", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 345.0, "discounted_cash": 69.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82378 CARCINOEMBRYONIC ANTIGEN", "code_information": [{"code": "82378", "type": "CPT"}, {"code": "104274", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82378 CEA BODY FLUID", "code_information": 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"outpatient", "billing_class": "facility"}]}, {"description": "HC 82384 CATECHOLAMINES URINE FRAC", "code_information": [{"code": "82384", "type": "CPT"}, {"code": "197039", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 57.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82390 ASSAY OF CERULOPLASMIN", "code_information": [{"code": "82390", "type": "CPT"}, {"code": "104286", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 281.0, "discounted_cash": 56.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82397 ADALIMUMAB AB", "code_information": [{"code": "82397", "type": "CPT"}, {"code": "197047", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 97.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82397 CHEMILUMINESCENT ASSAY", 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"type": "RC"}], "standard_charges": [{"gross_charge": 488.0, "discounted_cash": 97.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82435 ASSAY OF BLOOD CHLORIDE", "code_information": [{"code": "82435", "type": "CPT"}, {"code": "104290", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 155.0, "discounted_cash": 31.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82436 ASSAY OF URINE CHLORIDE", "code_information": [{"code": "82436", "type": "CPT"}, {"code": "104292", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 48.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82436 CHLORIDE URINE 24HR", "code_information": [{"code": "82436", "type": "CPT"}, {"code": "197051", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 48.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82436 CHLORIDE URINE 24HR", "code_information": [{"code": "82436", "type": "CPT"}, {"code": "199120", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 48.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82438 ASSAY, OTHER FLUID CHLORIDES", "code_information": [{"code": "82438", "type": "CPT"}, {"code": "104294", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 29.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82438 CHLORIDE FECAL", "code_information": [{"code": "82438", "type": "CPT"}, {"code": "197059", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 5.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82465 ASSAY, BLD/SERUM CHOLESTEROL", "code_information": [{"code": "82465", "type": "CPT"}, {"code": "104296", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 151.0, "discounted_cash": 30.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82480 ASSAY, SERUM CHOLINESTERASE", "code_information": [{"code": "82480", "type": "CPT"}, {"code": "104298", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 45.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82495 ASSAY OF CHROMIUM", "code_information": [{"code": "82495", "type": "CPT"}, {"code": "104306", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 64.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82507 ASSAY OF CITRATE", "code_information": [{"code": "82507", "type": "CPT"}, {"code": "104308", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 794.0, "discounted_cash": 158.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82523 COLLAGEN CROSSLINKS", "code_information": [{"code": "82523", "type": "CPT"}, {"code": "104312", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 66.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82523 COLLAGEN CROSSLINKS NTELOPEPTI", "code_information": [{"code": "82523", "type": "CPT"}, {"code": "197065", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 66.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82523 COLLAGEN CROSSLINKS TELOPEPTID", "code_information": [{"code": "82523", "type": "CPT"}, {"code": "197063", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 66.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82525 ASSAY OF COPPER", "code_information": [{"code": "82525", "type": "CPT"}, {"code": "104314", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 57.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82525 COPPER URINE", "code_information": [{"code": "82525", "type": "CPT"}, {"code": "197071", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 60.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82525 COPPER, 24 HR URINE", "code_information": [{"code": "82525", "type": "CPT"}, {"code": "163766", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 60.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82525 COPPER, TISSUE", "code_information": 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"type": "CPT"}, {"code": "202062", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 109.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82634 DEOXYCORTISOL", "code_information": [{"code": "82634", "type": "CPT"}, {"code": "104350", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 157.0, "discounted_cash": 31.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82642 DIHYDROTESTOSTERONE", "code_information": [{"code": "82642", "type": "CPT"}, {"code": "189544", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 34.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82652 ASSAY OF DIHYDROXYVITAMIN D", "code_information": [{"code": "82652", "type": "CPT"}, {"code": "104352", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": 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"300", "type": "RC"}], "standard_charges": [{"gross_charge": 236.0, "discounted_cash": 47.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82679 ASSAY OF ESTRONE", "code_information": [{"code": "82679", "type": "CPT"}, {"code": "104366", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82681 ASSAY DIRECT MEASUREMENT FREE ESTRADIOL", "code_information": [{"code": "82681", "type": "CPT"}, {"code": "242853", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 29.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82693 ETHYLENE GLYCOL, QUANTITATIVE", "code_information": [{"code": "82693", "type": "CPT"}, {"code": "191206", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 16.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82705 FATS/LIPIDS, FECES, QUAL", "code_information": [{"code": "82705", "type": "CPT"}, {"code": "104368", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 23.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82710 FATS/LIPIDS, FECES, QUANT", "code_information": [{"code": "82710", "type": "CPT"}, {"code": "104370", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 586.0, "discounted_cash": 117.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82725 ASSAY OF BLOOD FATTY ACIDS", "code_information": [{"code": "82725", "type": "CPT"}, {"code": "104374", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 105.0, "discounted_cash": 21.0, "setting": "outpatient", "billing_class": "facility"}]}, 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"300", "type": "RC"}], "standard_charges": [{"gross_charge": 395.0, "discounted_cash": 79.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82785 ASSAY OF GAMMAGLOBULIN IGE", "code_information": [{"code": "82785", "type": "CPT"}, {"code": "104388", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 44.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82787 IGG 1, 2, 3 OR 4, EACH", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "104390", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 6.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82787 IGG SUBCLASS 1", "code_information": [{"code": "82787", "type": "CPT"}, {"code": "197175", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 6.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82800 BLOOD PH", "code_information": [{"code": "82800", "type": "CPT"}, {"code": "104392", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 47.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82803 BLOOD GAS 3EN", "code_information": [{"code": "82803", "type": "CPT"}, {"code": "163796", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 161.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82803 BLOOD GAS, VENOUS", "code_information": [{"code": "82803", "type": "CPT"}, {"code": "163798", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 571.0, "discounted_cash": 114.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82803 VBG - COMPLETE", "code_information": [{"code": "82803", "type": "CPT"}, {"code": "210788", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 664.0, "discounted_cash": 132.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82805 BLOOD GASES W/02 SATURATION", "code_information": [{"code": "82805", "type": "CPT"}, {"code": "104396", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 905.0, "discounted_cash": 181.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82810 BLOOD GASES, O2 SAT ONLY", "code_information": [{"code": "82810", "type": "CPT"}, {"code": "104398", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 13.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82941 ASSAY OF GASTRIN", "code_information": [{"code": "82941", "type": "CPT"}, {"code": "104402", "type": "CDM"}, {"code": "300", "type": "RC"}], 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"facility"}]}, {"description": "HC 82945 GLUCOSE, URINE QUANT.", "code_information": [{"code": "82945", "type": "CPT"}, {"code": "163804", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 30.0, "discounted_cash": 6.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82947 ASSAY, GLUCOSE, BLOOD QUANT", "code_information": [{"code": "82947", "type": "CPT"}, {"code": "104408", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 30.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82948 REAGENT STRIP/BLOOD GLUCOSE", "code_information": [{"code": "82948", "type": "CPT"}, {"code": "104410", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 22.0, "discounted_cash": 4.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82950 GLUCOSE TEST", "code_information": [{"code": "82950", "type": "CPT"}, {"code": "104412", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 31.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82951 GLUCOSE TOLERANCE TEST (GTT)", "code_information": [{"code": "82951", "type": "CPT"}, {"code": "104414", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 62.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82952 GTT-ADDED SAMPLES", "code_information": [{"code": "82952", "type": "CPT"}, {"code": "104416", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 31.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82955 ASSAY OF G6PD ENZYME", "code_information": [{"code": "82955", "type": "CPT"}, {"code": "104418", "type": "CDM"}, {"code": "300", "type": "RC"}], 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"billing_class": "facility"}]}, {"description": "HC 82985 FRUCTOSAMINE", "code_information": [{"code": "82985", "type": "CPT"}, {"code": "197185", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 277.0, "discounted_cash": 55.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 82985 GLYCATED PROTEIN", "code_information": [{"code": "82985", "type": "CPT"}, {"code": "104430", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 430.0, "discounted_cash": 86.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83001 GONADOTROPIN (FSH)", "code_information": [{"code": "83001", "type": "CPT"}, {"code": "104432", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 389.0, "discounted_cash": 77.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83002 GONADOTROPIN (LH)", "code_information": [{"code": "83002", "type": "CPT"}, {"code": "104434", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 83.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83003 ASSAY, GROWTH HORMONE (HGH)", "code_information": [{"code": "83003", "type": "CPT"}, {"code": "104436", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 309.0, "discounted_cash": 61.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83010 ASSAY OF HAPTOGLOBIN, QUANT", "code_information": [{"code": "83010", "type": "CPT"}, {"code": "104438", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 376.0, "discounted_cash": 75.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83013 H PYLORI BREATH TEST", "code_information": [{"code": "83013", "type": "CPT"}, {"code": "191216", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 273.0, "discounted_cash": 54.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83018 HEAVY METALS BLOOD", "code_information": [{"code": "83018", "type": "CPT"}, {"code": "163818", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 834.0, "discounted_cash": 166.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83018 HEAVY METALS QN URINE", "code_information": [{"code": "83018", "type": "CPT"}, {"code": "197189", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 834.0, "discounted_cash": 166.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83018 IODINE-SERUM", "code_information": [{"code": "83018", "type": "CPT"}, {"code": "197191", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 834.0, "discounted_cash": 166.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83020 CAPILLARY ELECTROPHORESIS", "code_information": [{"code": "83020", "type": "CPT"}, {"code": "258565", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 7.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83020 HEMOGLOBIN ELECTROPHORESIS", "code_information": [{"code": "83020", "type": "CPT"}, {"code": "104444", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 264.0, "discounted_cash": 52.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83021 HEMOGLOBIN CHROMOTOGRAPHY", "code_information": [{"code": "83021", "type": "CPT"}, {"code": "104446", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 92.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83021 HEMOGLOBIN EVALUATION", "code_information": 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"type": "RC"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 66.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83080 B-HEXOSAMINIDASE, EACH ASSAY", "code_information": [{"code": "83080", "type": "CPT"}, {"code": "218817", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 307.0, "discounted_cash": 61.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83088 ASSAY OF HISTAMINE", "code_information": [{"code": "83088", "type": "CPT"}, {"code": "104462", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 149.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83088 HISTAMINE URINE", "code_information": [{"code": "83088", "type": "CPT"}, {"code": "197207", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 747.0, "discounted_cash": 149.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83090 ASSAY OF HOMOCYSTINE", "code_information": [{"code": "83090", "type": "CPT"}, {"code": "104464", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 470.0, "discounted_cash": 94.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83090 HOMOCYSTINE BLOOD", "code_information": [{"code": "83090", "type": "CPT"}, {"code": "197209", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 24.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83150 ASSAY OF FOR HVA", "code_information": [{"code": "83150", "type": "CPT"}, {"code": "104466", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 109.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83497 5-HIAA QUANT, 24 HR URINE", "code_information": [{"code": "83497", "type": "CPT"}, {"code": "163820", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 399.0, "discounted_cash": 79.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83497 ASSAY OF 5-HIAA", "code_information": [{"code": "83497", "type": "CPT"}, {"code": "104470", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 67.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83498 ASSAY OF PROGESTERONE", "code_information": [{"code": "83498", "type": "CPT"}, {"code": "104472", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 39.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83516 ACETYLCHOLINE RECEPTR BLOCK AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "197241", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83516 ACETYLCHOLINE RECEPTR MODUL AB", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "197213", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83516 ANTI C1Q IGG", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "197247", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 41.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83516 ANTI-SMOOTH MUSCLE ANTIBODY", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "163822", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83516 ASIALO GM1 AB IGM", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "197273", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 41.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83516 CELIAC DUAL ANTIGEN SCREEN", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "197255", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83516 CENTROMERE AB IGG TITER", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "197217", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83516 DEAMIDATED GLIADIN PEPTIDE ANTIBODY, IGA", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "259082", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 37.0, "discounted_cash": 7.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83516 DEAMIDATED GLIADIN PEPTIDE ANTIBODY, IGG", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "283839", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 41.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83516 FLUORESCENT ANTIBODY, SCREEN", "code_information": [{"code": "83516", "type": "CPT"}, {"code": "104946", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83516 GANGLIOSIDE GD1B AB", "code_information": [{"code": "83516", "type": 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66.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83690 ASSAY OF LIPASE", "code_information": [{"code": "83690", "type": "CPT"}, {"code": "104512", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 227.0, "discounted_cash": 45.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83695 ASSAY OF LIPOPROTEIN(A)", "code_information": [{"code": "83695", "type": "CPT"}, {"code": "104514", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 65.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83704 LIPOPROTEIN, BLD, BY NMR", "code_information": [{"code": "83704", "type": "CPT"}, {"code": "104516", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 421.0, "discounted_cash": 84.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83718 ASSAY OF 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"type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 186.0, "discounted_cash": 37.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83735 MAGNESIUM", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "163870", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 186.0, "discounted_cash": 37.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83735 MAGNESIUM URINE", "code_information": [{"code": "83735", "type": "CPT"}, {"code": "197427", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 186.0, "discounted_cash": 37.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83785 ASSAY OF MANGANESE", "code_information": [{"code": "83785", "type": "CPT"}, {"code": "104524", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 597.0, "discounted_cash": 119.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83789 BILE ACIDS FRACT TOTAL", "code_information": [{"code": "83789", "type": "CPT"}, {"code": "197431", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 25.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83789 MASS SPECTROMETRY QN", "code_information": [{"code": "83789", "type": "CPT"}, {"code": "197433", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 25.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83789 MASS SPECTROMETRY QUAL/QUAN", "code_information": [{"code": "83789", "type": "CPT"}, {"code": "104526", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 25.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83789 QUANTITATIVE SPEC COCOU", "code_information": [{"code": "83789", "type": "CPT"}, {"code": "191228", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 25.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83789 TRILEPTAL(HYDROXYCARBAZEPINE)", "code_information": [{"code": "83789", "type": "CPT"}, {"code": "163872", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 25.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83825 ASSAY OF MERCURY", "code_information": [{"code": "83825", "type": "CPT"}, {"code": "104528", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 101.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83825 MERCURY BLOOD", "code_information": [{"code": "83825", "type": "CPT"}, {"code": "163874", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 95.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83835 ASSAY OF METANEPHRINES", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "104530", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 397.0, "discounted_cash": 79.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83835 METANPHHRINES, FRACTIONATED", "code_information": [{"code": "83835", "type": "CPT"}, {"code": "163876", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 397.0, "discounted_cash": 79.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83873 ASSAY OF CSF PROTEIN", "code_information": [{"code": "83873", "type": "CPT"}, {"code": "104536", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 550.0, "discounted_cash": 110.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83874 ASSAY OF MYOGLOBIN", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "104538", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 496.0, "discounted_cash": 99.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83874 MYOGLOBIN URINE", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "197451", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 75.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83874 MYOGLOBIN, QUAN UR.", "code_information": [{"code": "83874", "type": "CPT"}, {"code": "163878", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 379.0, "discounted_cash": 75.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83880 BNP (B NATRIURETIC PEPTIDE)", "code_information": [{"code": "83880", "type": "CPT"}, {"code": "104540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 71.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83883 ASSAY, NEPHELOMETRY NOT SPEC", "code_information": [{"code": "83883", "type": "CPT"}, {"code": "104542", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 71.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83883 RETINOL BINDING PROTEIN", "code_information": [{"code": "83883", "type": "CPT"}, {"code": "197465", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 356.0, "discounted_cash": 71.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83915 ASSAY OF NUCLEOTIDASE", "code_information": [{"code": "83915", "type": "CPT"}, {"code": "104576", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 57.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83916 OLIGOCLONAL BANDS", "code_information": [{"code": "83916", "type": "CPT"}, {"code": "104578", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 446.0, "discounted_cash": 89.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83916 OLIGOCLONAL BANDS CSF SERUM", "code_information": [{"code": "83916", "type": "CPT"}, {"code": "197467", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 446.0, "discounted_cash": 89.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83918 ORGANIC ACIDS TOTAL QN URINE", "code_information": [{"code": "83918", "type": "CPT"}, {"code": "197471", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 23.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83918 ORGANIC ACIDS, TOTAL, QUANT", "code_information": [{"code": "83918", "type": "CPT"}, {"code": "104580", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 23.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83919 ORGANIC ACIDS SCREEN, U", "code_information": [{"code": "83919", "type": "CPT"}, {"code": "176457", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 442.0, "discounted_cash": 88.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83921 ORGANIC ACID, SINGLE, QUANT", "code_information": [{"code": "83921", "type": "CPT"}, {"code": "104582", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 374.0, "discounted_cash": 74.8, "setting": "outpatient", "billing_class": "facility"}]}, 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{"code": "197475", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 345.0, "discounted_cash": 69.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83951 ONCOPROTEIN DCP", "code_information": [{"code": "83951", "type": "CPT"}, {"code": "238715", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 486.0, "discounted_cash": 97.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83970 ASSAY OF PARATHORMONE", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "104592", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 898.0, "discounted_cash": 179.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83970 PARATHYROID HORMONE, INTACT", "code_information": [{"code": "83970", "type": "CPT"}, {"code": "163890", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": 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{"description": "HC 83986 PH BODY FLUID QUANT.", "code_information": [{"code": "83986", "type": "CPT"}, {"code": "163894", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 29.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83992 DRUG OF ABUSE PHENCYCLIDINE URINE", "code_information": [{"code": "83992", "type": "CPT"}, {"code": "202433", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 539.0, "discounted_cash": 107.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83992 PCP CONFIRM", "code_information": [{"code": "83992", "type": "CPT"}, {"code": "191238", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 539.0, "discounted_cash": 107.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 83993 CALPROTECTIN, FECAL", "code_information": [{"code": "83993", "type": "CPT"}, {"code": "184608", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 597.0, "discounted_cash": 119.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84030 84030 ASSAY OF BLOOD PKU", "code_information": [{"code": "84030", "type": "CPT"}, {"code": "104596", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 29.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84066 ASSAY PROSTATE PHOSPHATASE", "code_information": [{"code": "84066", "type": "CPT"}, {"code": "104600", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 42.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84075 ASSAY ALKALINE PHOSPHATASE", "code_information": [{"code": "84075", "type": "CPT"}, {"code": "104602", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 31.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84080 ASSAY ALKALINE PHOSPHATASES", "code_information": [{"code": "84080", "type": "CPT"}, {"code": "104606", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 309.0, "discounted_cash": 61.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84100 ASSAY OF PHOSPHORUS", "code_information": [{"code": "84100", "type": "CPT"}, {"code": "104610", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 151.0, "discounted_cash": 30.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84100 PHOSPHORUS (INORGANIC), SERUM", "code_information": [{"code": "84100", "type": "CPT"}, {"code": "191240", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 151.0, "discounted_cash": 30.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84105 PHOSPHORUS URINE QUAN.", "code_information": [{"code": "84105", "type": "CPT"}, {"code": "163900", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 31.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84110 ASSAY OF PORPHOBILINOGEN", "code_information": [{"code": "84110", "type": "CPT"}, {"code": "104616", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 59.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84110 PORPHOBILINOGEN, URINE; QUANTITATIVE", "code_information": [{"code": "84110", "type": "CPT"}, {"code": "191242", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 295.0, "discounted_cash": 59.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84112 AMNISURE, EVAL AMNIOTIC FLD PROTEIN", "code_information": [{"code": "84112", "type": "CPT"}, {"code": "180035", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 464.0, "discounted_cash": 92.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84112 ROM PLUS (FETAL MEMBRANES RUPTURE TEST)", "code_information": [{"code": "84112", "type": "CPT"}, {"code": "178500", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 178.0, "discounted_cash": 35.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84120 PORPHYRINS, 24 HR URINE", "code_information": [{"code": "84120", "type": "CPT"}, {"code": "163902", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 509.0, "discounted_cash": 101.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84120 PORPHYRINS, FRAC RANDOM URINE", "code_information": [{"code": "84120", "type": "CPT"}, {"code": "163904", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 497.0, "discounted_cash": 99.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84132 ASSAY OF SERUM POTASSIUM", "code_information": [{"code": "84132", "type": "CPT"}, {"code": "104622", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84132 POTASSIUM BLOOD POC", "code_information": [{"code": "84132", "type": "CPT"}, {"code": "199192", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 49.0, "discounted_cash": 9.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84133 ASSAY OF URINE POTASSIUM", "code_information": [{"code": "84133", "type": "CPT"}, {"code": "104624", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": 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"facility"}]}, {"description": "HC 84134 ASSAY OF PREALBUMIN", "code_information": [{"code": "84134", "type": "CPT"}, {"code": "104626", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 407.0, "discounted_cash": 81.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84140 ASSAY OF PREGNENOLONE", "code_information": [{"code": "84140", "type": "CPT"}, {"code": "104632", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 300.0, "discounted_cash": 60.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84143 ASSAY OF 17-HYDROXYPREGNENO", "code_information": [{"code": "84143", "type": "CPT"}, {"code": "238717", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 170.0, "discounted_cash": 34.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84144 ASSAY OF PROGESTERONE", "code_information": [{"code": "84144", "type": "CPT"}, {"code": "104634", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 358.0, "discounted_cash": 71.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84145 ASSAY OF PROCALCITONIN", "code_information": [{"code": "84145", "type": "CPT"}, {"code": "104636", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 529.0, "discounted_cash": 105.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84146 ASSAY OF PROLACTIN", "code_information": [{"code": "84146", "type": "CPT"}, {"code": "104638", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 95.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84153 ASSAY OF PSA, TOTAL", "code_information": [{"code": "84153", "type": "CPT"}, {"code": "104640", "type": "CDM"}, {"code": "300", "type": "RC"}], 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"billing_class": "facility"}]}, {"description": "HC 84156 FREE LIGHT CHAINS", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "261637", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 155.0, "discounted_cash": 31.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84156 TOTAL PROTEIN", "code_information": [{"code": "84156", "type": "CPT"}, {"code": "197501", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 155.0, "discounted_cash": 31.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84157 ASSAY OF PROTEIN, OTHER", "code_information": [{"code": "84157", "type": "CPT"}, {"code": "104648", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 28.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84157 PROTEIN, CSF (SPINAL FLUID)", "code_information": 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"billing_class": "facility"}]}, {"description": "HC 84182 CREUTZFELDT JAKOB WB", "code_information": [{"code": "84182", "type": "CPT"}, {"code": "197513", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84182 PROTEIN, WESTERN BLOT TEST", "code_information": [{"code": "84182", "type": "CPT"}, {"code": "104656", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84202 ASSAY RBC PROTOPORPHYRIN", "code_information": [{"code": "84202", "type": "CPT"}, {"code": "104658", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 393.0, "discounted_cash": 78.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84206 ASSAY OF PROINSULIN", "code_information": [{"code": "84206", "type": "CPT"}, {"code": "104660", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 461.0, "discounted_cash": 92.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84207 ASSAY OF VITAMIN B-6", "code_information": [{"code": "84207", "type": "CPT"}, {"code": "104662", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84210 ASSAY OF PYRUVATE", "code_information": [{"code": "84210", "type": "CPT"}, {"code": "104664", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 39.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84220 PYRUVATE KINASE", "code_information": [{"code": "84220", "type": "CPT"}, {"code": "191260", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 14.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84238 ASSAY, NONENDOCRINE RECEPTOR", "code_information": [{"code": "84238", "type": "CPT"}, {"code": "104670", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 917.0, "discounted_cash": 183.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84238 SOLUABLE TRANSFERRIN RECEPTOR", "code_information": [{"code": "84238", "type": "CPT"}, {"code": "197519", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 917.0, "discounted_cash": 183.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84244 ASSAY OF RENIN", "code_information": [{"code": "84244", "type": "CPT"}, {"code": "104672", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 100.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84252 VITB2-RIBOFLAVIN", "code_information": [{"code": "84252", "type": "CPT"}, {"code": "191262", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 28.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84255 ASSAY OF SELENIUM", "code_information": [{"code": "84255", "type": "CPT"}, {"code": "104674", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 247.0, "discounted_cash": 49.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84260 ASSAY OF SEROTONIN", "code_information": [{"code": "84260", "type": "CPT"}, {"code": "104676", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1084.0, "discounted_cash": 216.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84270 ASSAY OF SEX HORMONE GLOBUL", "code_information": [{"code": "84270", "type": "CPT"}, {"code": "104678", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 42.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84270 SEX HORMONE BINDING GLOBULIN SHBG", "code_information": [{"code": "84270", "type": "CPT"}, {"code": "191264", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 42.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84295 ASSAY OF SERUM SODIUM", "code_information": [{"code": "84295", "type": "CPT"}, {"code": "104680", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 31.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84295 SODIUM BLOOD POC", "code_information": [{"code": "84295", "type": "CPT"}, {"code": "199196", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 51.0, "discounted_cash": 10.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84300 ASSAY OF URINE SODIUM", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "104682", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 29.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84300 ASSAY OF URINE SODIUM .2", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "199198", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 29.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84300 SODIUM 24 HR URINE", "code_information": [{"code": "84300", "type": "CPT"}, {"code": "163918", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 29.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84302 ASSAY OF SODIUM OTHER SOURCE", "code_information": [{"code": "84302", "type": "CPT"}, {"code": "197529", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 38.0, "discounted_cash": 7.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84305 ASSAY OF SOMATOMEDIN", "code_information": [{"code": "84305", "type": "CPT"}, {"code": "104686", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 280.0, "discounted_cash": 56.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84311 CHOLESTEROL BODY FLUID", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "196915", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 338.0, "discounted_cash": 67.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84311 PHOSPHOLIPIDS, SERUM", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "163920", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 281.0, "discounted_cash": 56.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84311 SPECTROPHOTOMETRY", "code_information": [{"code": "84311", "type": "CPT"}, {"code": "104688", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 362.0, "discounted_cash": 72.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84376 REDUCING SUBSTANCE, F", "code_information": [{"code": "84376", "type": "CPT"}, {"code": "191270", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 30.0, "discounted_cash": 6.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84392 SULFATE URINE", "code_information": [{"code": "84392", "type": "CPT"}, {"code": "295974", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 236.0, "discounted_cash": 47.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84403 ASSAY OF TOTAL TESTOSTERONE", "code_information": [{"code": "84403", "type": "CPT"}, {"code": "104694", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 549.0, "discounted_cash": 109.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84410 BIOAVAILABLE", "code_information": [{"code": "84410", "type": "CPT"}, {"code": "191272", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 402.0, "discounted_cash": 80.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84425 ASSAY OF VITAMIN B-1", "code_information": [{"code": "84425", "type": "CPT"}, {"code": "104696", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 489.0, "discounted_cash": 97.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84425 VITAMIN B-1 WHOLE BLOOD", "code_information": [{"code": "84425", "type": "CPT"}, {"code": "197549", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 489.0, "discounted_cash": 97.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84432 ASSAY OF THYROGLOBULIN", "code_information": [{"code": "84432", "type": "CPT"}, {"code": "104700", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 36.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84433 THIOPURINE S-METHYLTRANSFERASE, RBC", "code_information": [{"code": "84433", "type": "CPT"}, {"code": "258808", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 18.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84436 ASSAY OF TOTAL THYROXINE", "code_information": [{"code": "84436", "type": "CPT"}, {"code": "104702", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 50.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84439 ASSAY OF FREE THYROXINE", "code_information": [{"code": "84439", "type": "CPT"}, {"code": "104704", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 68.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84439 T4 FREE, DIRECT DIALYSIS", "code_information": [{"code": "84439", "type": "CPT"}, {"code": "163922", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 342.0, "discounted_cash": 68.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84442 ASSAY OF THYROID ACTIVITY", "code_information": [{"code": "84442", "type": "CPT"}, {"code": "104706", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 489.0, "discounted_cash": 97.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84443 ASSAY THYROID STIM HORMONE", "code_information": [{"code": "84443", "type": "CPT"}, {"code": "104708", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 415.0, "discounted_cash": 83.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84443 TSH 3RD GENERATION", "code_information": [{"code": "84443", "type": "CPT"}, {"code": "197551", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 434.0, "discounted_cash": 86.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84443 TSH HIGH SENSITIVITY", "code_information": [{"code": "84443", "type": "CPT"}, {"code": "163924", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 436.0, "discounted_cash": 87.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84445 THYROID-STIMULATING IMMUNOGLOB", "code_information": [{"code": "84445", "type": "CPT"}, {"code": "176455", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 710.0, "discounted_cash": 142.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84446 ASSAY OF VITAMIN E", "code_information": [{"code": "84446", "type": "CPT"}, {"code": "104712", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 50.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84450 TRANSFERASE (AST) (SGOT)", "code_information": [{"code": "84450", "type": "CPT"}, {"code": "104714", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 39.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84460 ALANINE AMINO (ALT) (SGPT)", "code_information": [{"code": "84460", "type": "CPT"}, {"code": "104716", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 39.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84460 ALANINE AMINOTRANSFERASE", "code_information": [{"code": "84460", "type": "CPT"}, {"code": "197553", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 199.0, "discounted_cash": 39.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84466 ASSAY OF TRANSFERRIN", "code_information": [{"code": "84466", "type": "CPT"}, {"code": "104718", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 399.0, "discounted_cash": 79.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84478 ASSAY OF TRIGLYCERIDES", "code_information": [{"code": "84478", "type": "CPT"}, {"code": "104720", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 46.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84479 ASSAY OF THYROID (T3 OR T4)", "code_information": [{"code": "84479", "type": "CPT"}, {"code": "104722", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 68.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84479 THYROID UPTAKE T3 OR T4", "code_information": [{"code": "84479", "type": "CPT"}, {"code": "197557", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 68.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84480 ASSAY, TRIIODOTHYRONINE (T3)", "code_information": [{"code": "84480", "type": "CPT"}, {"code": "104724", "type": "CDM"}, {"code": "300", "type": "RC"}], 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"facility"}]}, {"description": "HC 84490 ASSAY OF FECES FOR TRYPSIN", "code_information": [{"code": "84490", "type": "CPT"}, {"code": "104732", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 72.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84520 ASSAY OF UREA NITROGEN", "code_information": [{"code": "84520", "type": "CPT"}, {"code": "104734", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 188.0, "discounted_cash": 37.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84540 ASSAY OF URINE/UREA-N", "code_information": [{"code": "84540", "type": "CPT"}, {"code": "104736", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 28.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84545 UREA-N CLEARANCE TEST", "code_information": [{"code": "84545", "type": "CPT"}, {"code": "104738", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 236.0, "discounted_cash": 47.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84550 ASSAY OF BLOOD/URIC ACID", "code_information": [{"code": "84550", "type": "CPT"}, {"code": "104740", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 27.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84560 ASSAY OF URINE/URIC ACID", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "104742", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 29.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84560 URIC ACID 24HR URINE", "code_information": [{"code": "84560", "type": "CPT"}, {"code": "197569", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 29.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84585 ASSAY OF URINE VMA", "code_information": [{"code": "84585", "type": "CPT"}, {"code": "104750", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 358.0, "discounted_cash": 71.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84586 ASSAY OF VIP", "code_information": [{"code": "84586", "type": "CPT"}, {"code": "104752", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 845.0, "discounted_cash": 169.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84588 ASSAY OF VASOPRESSIN", "code_information": [{"code": "84588", "type": "CPT"}, {"code": "104754", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 779.0, "discounted_cash": 155.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84590 ASSAY OF VITAMIN A", "code_information": [{"code": "84590", "type": "CPT"}, {"code": "104756", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 461.0, "discounted_cash": 92.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84591 VITAMIN B7 REF1", "code_information": [{"code": "84591", "type": "CPT"}, {"code": "295978", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 574.0, "discounted_cash": 114.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84597 ASSAY OF VITAMIN K", "code_information": [{"code": "84597", "type": "CPT"}, {"code": "104758", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 84.0, "discounted_cash": 16.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84600 ASSAY OF VOLATILES", "code_information": [{"code": "84600", "type": "CPT"}, {"code": "104760", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 66.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84630 ASSAY OF ZINC", "code_information": [{"code": "84630", "type": "CPT"}, {"code": "104764", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 282.0, "discounted_cash": 56.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84681 ASSAY OF C-PEPTIDE", "code_information": [{"code": "84681", "type": "CPT"}, {"code": "104766", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 40.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84702 CHORIONIC GONADOTROPIN TEST", "code_information": [{"code": "84702", "type": "CPT"}, {"code": "104768", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": 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"facility"}]}, {"description": "HC 84999 POTASSIUM FECAL", "code_information": [{"code": "84999", "type": "CPT"}, {"code": "197587", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 80.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 84999 UNLISTED CHEMISTRY PROC", "code_information": [{"code": "84999", "type": "CPT"}, {"code": "197581", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 401.0, "discounted_cash": 80.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85004 AUTOMATED DIFF WBC COUNT", "code_information": [{"code": "85004", "type": "CPT"}, {"code": "104776", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 139.0, "discounted_cash": 27.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85007 BL SMEAR W/DIFF WBC COUNT", "code_information": [{"code": "85007", "type": "CPT"}, {"code": "104778", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 24.0, "discounted_cash": 4.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85007 PERIPHERAL SMEAR", "code_information": [{"code": "85007", "type": "CPT"}, {"code": "163940", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85014 HEMATOCRIT", "code_information": [{"code": "85014", "type": "CPT"}, {"code": "104784", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 3.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85014 HEMATOCRIT FLUID", "code_information": [{"code": "85014", "type": "CPT"}, {"code": "198059", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 112.0, "discounted_cash": 22.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85018 HEMOGLOBIN", "code_information": [{"code": "85018", "type": "CPT"}, {"code": "104786", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 17.0, "discounted_cash": 3.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85018 HEMOGLOBIN", "code_information": [{"code": "85018", "type": "CPT"}, {"code": "199354", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 119.0, "discounted_cash": 23.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85018 HEMOGLOBIN .3", "code_information": [{"code": "85018", "type": "CPT"}, {"code": "198065", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 23.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85025 COMPLETE CBC W/AUTO DIFF WBC", "code_information": [{"code": "85025", "type": "CPT"}, {"code": "104788", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 9.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85027 COMPLETE CBC, AUTOMATED", "code_information": [{"code": "85027", "type": "CPT"}, {"code": "104790", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 39.0, "discounted_cash": 7.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85041 AUTOMATED RBC COUNT", "code_information": [{"code": "85041", "type": "CPT"}, {"code": "104792", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 58.0, "discounted_cash": 11.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85045 AUTOMATED RETICULOCYTE COUNT", "code_information": [{"code": "85045", "type": "CPT"}, {"code": "104796", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 28.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85048 WBC COUNT (BLOOD)", "code_information": [{"code": "85048", "type": "CPT"}, {"code": "163950", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 19.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85049 AUTOMATED PLATELET COUNT", "code_information": [{"code": "85049", "type": "CPT"}, {"code": "104800", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 31.0, "discounted_cash": 6.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85055 IMMATURE PLATELET FRACTION", "code_information": [{"code": "85055", "type": "CPT"}, {"code": "198069", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 38.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85060 BLOOD SMEAR INTERPRETATION", "code_information": [{"code": "85060", "type": "CPT"}, {"code": "104802", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 27.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85097 BONE MARROW ASP", "code_information": [{"code": "85097", "type": "CPT"}, {"code": "191282", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 2331.0, "discounted_cash": 466.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85210 BLOOD CLOT FACTOR II TEST", "code_information": [{"code": "85210", "type": "CPT"}, {"code": "104808", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 65.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85220 BLOOD CLOT FACTOR V TEST", "code_information": [{"code": "85220", "type": "CPT"}, {"code": "104810", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 321.0, "discounted_cash": 64.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85230 BLOOD CLOT FACTOR VII TEST", "code_information": [{"code": "85230", "type": "CPT"}, {"code": "104812", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 327.0, "discounted_cash": 65.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85240 BLOOD CLOT FACTOR VIII TEST", "code_information": [{"code": "85240", "type": "CPT"}, {"code": "104814", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 812.0, "discounted_cash": 162.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85245 BLOOD CLOT FACTOR VIII TEST", "code_information": [{"code": "85245", "type": "CPT"}, {"code": "104816", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 145.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85245 RISTOCETIN COFACTOR", "code_information": [{"code": "85245", "type": "CPT"}, {"code": "163952", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 464.0, "discounted_cash": 92.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85246 BLOOD CLOT FACTOR VIII TEST", "code_information": [{"code": "85246", "type": "CPT"}, {"code": "104818", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85246 CLOTTING; FACTOR VIII, VW FACTOR ANTIGEN", "code_information": [{"code": "85246", "type": "CPT"}, {"code": "191286", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85247 BLOOD CLOT FACTOR VIII TEST", "code_information": [{"code": "85247", "type": "CPT"}, {"code": "104820", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 984.0, "discounted_cash": 196.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85250 BLOOD CLOT FACTOR IX TEST", "code_information": [{"code": "85250", "type": "CPT"}, {"code": "104822", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 773.0, "discounted_cash": 154.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85260 BLOOD CLOT FACTOR X TEST", "code_information": [{"code": "85260", "type": "CPT"}, {"code": "104824", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 321.0, "discounted_cash": 64.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85270 BLOOD CLOT FACTOR XI TEST", "code_information": [{"code": "85270", "type": "CPT"}, {"code": "104826", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 321.0, "discounted_cash": 64.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85280 BLOOD CLOT FACTOR XII TEST", "code_information": [{"code": "85280", "type": "CPT"}, {"code": "104828", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 321.0, "discounted_cash": 64.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85300 ANTITHROMBIN III TEST", "code_information": [{"code": "85300", "type": "CPT"}, {"code": "104830", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 354.0, "discounted_cash": 70.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85301 ANTITHROMBIN III TEST", "code_information": [{"code": "85301", "type": "CPT"}, {"code": "104832", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 341.0, "discounted_cash": 68.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85302 BLOOD CLOT INHIBITOR ANTIGEN", "code_information": [{"code": "85302", "type": "CPT"}, {"code": "104834", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 821.0, "discounted_cash": 164.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85303 BLOOD CLOT INHIBITOR TEST", "code_information": [{"code": "85303", "type": "CPT"}, {"code": "104836", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 723.0, "discounted_cash": 144.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85303 CLOTTING INHIBITORS, ANTICOAGULANTS; PROTEIN C,ACTIVITY", "code_information": [{"code": "85303", "type": "CPT"}, {"code": "191290", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 723.0, "discounted_cash": 144.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85305 PROTEIN S, ANTIGEN TOTAL", "code_information": [{"code": "85305", "type": "CPT"}, {"code": "104838", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 821.0, "discounted_cash": 164.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85306 BLOOD CLOT INHIBITOR TEST", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "104840", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 765.0, "discounted_cash": 153.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85306 PROTEIN S, FREE", "code_information": [{"code": "85306", "type": "CPT"}, {"code": "163954", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": 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"facility"}]}, {"description": "HC 85347 COAGULATION TIME TEG", "code_information": [{"code": "85347", "type": "CPT"}, {"code": "198089", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 201.0, "discounted_cash": 40.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85347 WAVECREST ACT", "code_information": [{"code": "85347", "type": "CPT"}, {"code": "202131", "type": "CDM"}, {"code": "990", "type": "RC"}], "standard_charges": [{"gross_charge": 61.0, "discounted_cash": 12.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85362 FIBRIN DEGRADATION PRODUCTS", "code_information": [{"code": "85362", "type": "CPT"}, {"code": "104852", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85378 FIBRIN DEGRADE, SEMIQUANT", "code_information": [{"code": "85378", "type": "CPT"}, {"code": "104856", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 375.0, "discounted_cash": 75.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85379 D DIMER QT", "code_information": [{"code": "85379", "type": "CPT"}, {"code": "295982", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 394.0, "discounted_cash": 78.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85384 FIBRINOGEN", "code_information": [{"code": "85384", "type": "CPT"}, {"code": "104858", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 224.0, "discounted_cash": 44.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85384 FIBRINOGEN ACTIVITY TEG", "code_information": [{"code": "85384", "type": "CPT"}, {"code": "198091", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 224.0, "discounted_cash": 44.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85390 FIBRINOLYSINS OR COAGULOPATHY SCRN", "code_information": [{"code": "85390", "type": "CPT"}, {"code": "176451", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 57.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85397 ADAMTS13 ACTIVITY", "code_information": [{"code": "85397", "type": "CPT"}, {"code": "198093", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 18.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85415 FIBRINOLYTIC PLASMINOGEN", "code_information": [{"code": "85415", "type": "CPT"}, {"code": "189546", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 118.0, "discounted_cash": 23.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85460 HEMOGLOBIN, FETAL", "code_information": [{"code": "85460", "type": "CPT"}, {"code": "104862", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 612.0, "discounted_cash": 122.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85461 HEMOGLOBIN, FETAL", "code_information": [{"code": "85461", "type": "CPT"}, {"code": "104864", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 139.0, "discounted_cash": 27.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85520 HEPARIN ASSAY", "code_information": [{"code": "85520", "type": "CPT"}, {"code": "104868", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 728.0, "discounted_cash": 145.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85525 LUP PTT NEUTRALIZED 1", "code_information": [{"code": "85525", "type": "CPT"}, {"code": "212370", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 16.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85549 MURAMIDASE", "code_information": [{"code": "85549", "type": "CPT"}, {"code": "104872", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 68.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85555 RBC OSMOTIC FRAGILITY", "code_information": [{"code": "85555", "type": "CPT"}, {"code": "238733", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 73.0, "discounted_cash": 14.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85557 RBC OSMOTIC FRAGILITY", "code_information": [{"code": "85557", "type": "CPT"}, {"code": "104874", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 345.0, "discounted_cash": 69.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85576 ADP AGGREGATION", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "176539", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 85.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85576 BLOOD PLATELET AGGREGATION", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "104876", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 85.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85576 PLATELET AGGREGATION IN VITRO", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "198109", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 85.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85576 PLATELET AGGREGATION TRAP", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "198105", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 429.0, "discounted_cash": 85.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85576 PLATELET AGGREGATION,EA STUDY", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "163958", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1031.0, "discounted_cash": 206.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85576 PLATELET FUNCTION, ASPIRIN", "code_information": [{"code": "85576", "type": "CPT"}, {"code": "163960", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 452.0, "discounted_cash": 90.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85597 PHOSPHOLIPID NEUTRALIZ; PLATELET", "code_information": [{"code": "85597", "type": "CPT"}, {"code": "177299", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 39.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85597 PLATELET NEUTRALIZATION.2", "code_information": [{"code": "85597", "type": "CPT"}, {"code": "198111", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 39.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85598 PHOSPHOLIPID NEUTRALIZ HEXAGNL", "code_information": [{"code": "85598", "type": "CPT"}, {"code": "197591", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 19.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85598 STACLOT LA, P", "code_information": [{"code": "85598", "type": "CPT"}, {"code": "191302", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 99.0, "discounted_cash": 19.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85610 LUPUS ANTICOAG PROTHROMBIN TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "242983", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 44.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85610 PROTHROMBIN TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "104880", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 26.0, "discounted_cash": 5.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85610 PROTIME (PROTHROMBIN) TIME", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "163962", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 43.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85610 PROTIME, POCT WAIVED", "code_information": [{"code": "85610", "type": "CPT"}, {"code": "202797", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 44.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85613 APS LUPUS ANTICOAGULANT", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "163966", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 45.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85613 DRVVT CONFIRM RATIO", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "191306", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 127.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85613 LUPUS ANTICOAG RUSSELL VIPER", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "242987", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 127.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85613 RUSSELL VIPER VENOM, DILUTED", "code_information": [{"code": "85613", "type": "CPT"}, {"code": "104882", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 638.0, "discounted_cash": 127.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85635 LUP REPTILASE TIME", "code_information": [{"code": "85635", "type": "CPT"}, {"code": "212372", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 13.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85635 REPTILASE TIME, P", "code_information": [{"code": "85635", "type": "CPT"}, {"code": "229332", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 13.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85651 RBC SED RATE, NONAUTOMATED", "code_information": [{"code": "85651", "type": "CPT"}, {"code": "104884", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 24.0, "discounted_cash": 4.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85652 RBC SED RATE, AUTOMATED", "code_information": [{"code": "85652", "type": "CPT"}, {"code": "104886", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 28.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85660 HEMOGLOBIN S SCREEN", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "176453", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 57.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85660 SICKLE CELL SOLUBILITY REFLEX", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "258581", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 27.0, "discounted_cash": 5.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85660 SICKLE CELL STUDY/PREP", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "104888", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 28.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85660 SICKLE SCREEN PER BLOOD UNIT", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "163972", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 29.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85660 SICKLEDEX", "code_information": [{"code": "85660", "type": "CPT"}, {"code": "163970", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 21.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85670 THROMBIN TIME, PLASMA", "code_information": [{"code": "85670", "type": "CPT"}, {"code": "104890", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 174.0, "discounted_cash": 34.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85730 LUPUS ANTICOAG THROMBOPLASTIN", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "242985", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 49.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85730 PTT HEPARIN NEUTRALIZED", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "198123", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 49.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85730 PTT, POCT NON-WAIVED", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "163978", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 51.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85730 PTT, VON WILL PANEL", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "163976", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 309.0, "discounted_cash": 61.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85730 THROMBOPLASTIN TIME, PARTIAL", "code_information": [{"code": "85730", "type": "CPT"}, {"code": "104892", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 249.0, "discounted_cash": 49.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85732 APTT MIX 1-1", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "229328", "type": "CDM"}, {"code": "305", "type": "RC"}], "standard_charges": [{"gross_charge": 144.0, "discounted_cash": 28.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85732 THROMBOPLASTIN TIME PARTIAL(PTT), EA", "code_information": [{"code": "85732", "type": "CPT"}, {"code": "177301", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 33.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 85810 BLOOD VISCOSITY EXAMINATION", "code_information": [{"code": "85810", "type": "CPT"}, {"code": "104896", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 399.0, "discounted_cash": 79.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86000 TULAREMIA", "code_information": [{"code": "86000", "type": "CPT"}, {"code": "163982", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 15.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86001 ALLERGEN SPECIFIC IGG", "code_information": [{"code": "86001", "type": "CPT"}, {"code": "191310", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 59.0, "discounted_cash": 11.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86003 A FUMIGATUS, IGE", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "191312", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 8.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86003 ALLERGEN SPECIFIC IGE", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "104900", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 8.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86003 ALLERGEN SPECIFIC IGE", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "261826", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 8.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86003 FOOD PANEL 6", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "191316", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 8.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86003 HOUSE DUST PANEL, IGE", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "199671", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 8.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86003 RAST INDIVIDUAL EACH", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "197615", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 8.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86003 RAST INDIVIDUAL REF EACH", "code_information": [{"code": "86003", "type": "CPT"}, {"code": "197617", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 8.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86005 ALLERGEN SPEC IGE QUAL MULTIALLG SCRN", "code_information": [{"code": "86005", "type": "CPT"}, {"code": "176515", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 42.0, "discounted_cash": 8.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86008 RAST INDIVIDUAL EA", "code_information": [{"code": "86008", "type": "CPT"}, {"code": "197623", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 30.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86015 F ACTIN AB", "code_information": [{"code": "86015", "type": "CPT"}, {"code": "197593", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 9.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86021 WBC ANTIBODY IDENTIFICATION", "code_information": [{"code": "86021", "type": "CPT"}, {"code": "104902", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, "discounted_cash": 34.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86022 HEPARIN PF4 ANTIBODY", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "197627", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 615.0, "discounted_cash": 123.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86022 PLATELET AB, INDIRECT", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "163986", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 62.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86022 PLATELET ANTIBODIES", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "104904", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 615.0, "discounted_cash": 123.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86022 SEROTONIN RELEASE ASSAY", "code_information": [{"code": "86022", "type": "CPT"}, {"code": "163988", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 507.0, "discounted_cash": 101.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86023 IMMUNOGLOBULIN ASSAY", "code_information": [{"code": "86023", "type": "CPT"}, {"code": "104906", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 62.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86023 PLAT ASSOC AB DIRECT IGM", "code_information": [{"code": "86023", "type": "CPT"}, {"code": "197633", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 311.0, "discounted_cash": 62.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86023 PLT IMMUNOGLOBULIN ASSAY", "code_information": [{"code": "86023", "type": "CPT"}, {"code": "258264", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 171.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86036 ANCA SCREEN EACH ANTIBODY", "code_information": [{"code": "86036", "type": "CPT"}, {"code": "191347", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 9.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86038 ANTINUCLEAR ANTIBODIES", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "104908", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 228.0, "discounted_cash": 45.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86038 ANTINUCLEAR ANTIBODIES .2", "code_information": [{"code": "86038", "type": "CPT"}, {"code": "197635", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 228.0, "discounted_cash": 45.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86039 ANTINUCLEAR ANTIBODIES (ANA)", "code_information": [{"code": "86039", "type": "CPT"}, {"code": "104910", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 95.0, "discounted_cash": 19.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86041 ACETYLCHOLINE RECEPTOR (ACHR); BINDING ANTIBODY", "code_information": [{"code": "86041", "type": "CPT"}, {"code": "292588", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 7.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86042 ACETYLCHOLINE RECEPTOR (ACHR); BLOCKING ANTIBODY", "code_information": [{"code": "86042", "type": "CPT"}, {"code": "292590", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 35.0, "discounted_cash": 7.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86043 ACETYLCHOLINE RECEPTOR (ACHR); MODULATING ANTIBODY", "code_information": [{"code": "86043", "type": "CPT"}, {"code": "292592", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 6.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86051 AQUAPORIN-4 ANTB ELISA", "code_information": [{"code": "86051", "type": "CPT"}, {"code": "189548", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 260.0, "discounted_cash": 52.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86052 AQUAPORIN-4 ANTB CBA EACH", "code_information": [{"code": "86052", "type": "CPT"}, {"code": "189550", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 238.0, "discounted_cash": 47.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86060 ANTISTREPTOLYSIN O, TITER", "code_information": [{"code": "86060", "type": "CPT"}, {"code": "104912", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 27.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86078 TRANSFUSION REAC PART", "code_information": [{"code": "86078", "type": "CPT"}, {"code": "191328", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 703.0, "discounted_cash": 140.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86140 C-REACTIVE PROTEIN", "code_information": [{"code": "86140", "type": "CPT"}, {"code": "104916", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 23.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86141 C-REACTIVE PROTEIN, HS", "code_information": [{"code": "86141", "type": "CPT"}, {"code": "104918", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 25.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86146 B2 GLYCOPROTTEIN IGG", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "191330", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 25.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86146 GLYCOPROTEIN ANTIBODY", "code_information": [{"code": "86146", "type": "CPT"}, {"code": "104920", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 25.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86147 CARDILIPIN ABS, IGM", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "163992", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 38.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86147 CARDIOLIPIN AB IGG", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "197647", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 23.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86147 CARDIOLIPIN ANTIBODY", "code_information": [{"code": "86147", "type": "CPT"}, {"code": "104922", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 116.0, "discounted_cash": 23.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86148 ANTI PHOSPHATIDYLSERINE AB IGM", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "197651", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 25.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86148 PHOSPHOLIPID ANTIBODY", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "104924", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 19.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86148 PHOSPHOLIPID ANTIBODY.2", "code_information": [{"code": "86148", "type": "CPT"}, {"code": "197649", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 25.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86157 COLD AGGLUTININ, TITER", "code_information": [{"code": "86157", "type": "CPT"}, {"code": "104926", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 22.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86160 C1 ESTERASE INHIBITOR QN", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "197661", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 273.0, "discounted_cash": 54.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86160 C1Q COMPLEMENT COMPONENT", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "197653", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 273.0, "discounted_cash": 54.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86160 C4 COMPLEMENT", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "163994", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 273.0, "discounted_cash": 54.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86160 COMPLEMENT, ANTIGEN", "code_information": [{"code": "86160", "type": "CPT"}, {"code": "104928", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 273.0, "discounted_cash": 54.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86161 COMPLEMENT/FUNCTION ACTIVITY.2", "code_information": [{"code": "86161", "type": "CPT"}, {"code": "197675", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 16.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86162 COMPLEMENT, TOTAL (CH50)", "code_information": [{"code": "86162", "type": "CPT"}, {"code": "104932", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 343.0, "discounted_cash": 68.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86171 ROCKY MOUNTAIN SPOTTED FEVER", "code_information": [{"code": "86171", "type": "CPT"}, {"code": "164002", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 29.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86200 ANTI CYCLIC CITRULLINATED PEPTIDE", "code_information": [{"code": "86200", "type": "CPT"}, {"code": "199547", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 25.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86200 CCP ANTIBODY", "code_information": [{"code": "86200", "type": "CPT"}, {"code": "104938", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 25.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86215 DEOXYRIBONUCLEASE ANTIBODY", "code_information": [{"code": "86215", "type": "CPT"}, {"code": "176519", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 23.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86225 DNA ANTIBODY", "code_information": [{"code": "86225", "type": "CPT"}, {"code": "104940", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 37.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86225 DNA DBL-STRAND AB", "code_information": [{"code": "86225", "type": "CPT"}, {"code": "191332", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 243.0, "discounted_cash": 48.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86226 DNA ANTIBODY, SINGLE STRAND", "code_information": [{"code": "86226", "type": "CPT"}, {"code": "104942", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 468.0, "discounted_cash": 93.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86231 ENDOMYSIAL AB EACH IG CLASS", "code_information": [{"code": "86231", "type": "CPT"}, {"code": "197679", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 9.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 ANTI-ENA", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "164004", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 464.0, "discounted_cash": 92.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 CENTROMERE B AB", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "163990", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 182.0, "discounted_cash": 36.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 ENA RNP", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "197693", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 41.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 ENA SCL70", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "197703", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 41.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 ENA U1SNRNP", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "197695", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 54.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 EXTRACTABLE NUC AG OR AB", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "197697", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 54.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 JO-1 ANTIBODY", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "164006", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 265.0, "discounted_cash": 53.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 NUCLEAR ANTIGEN ANTIBODY", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "104944", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 41.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 NUCLEAR ANTIGEN ANTIBODY.2", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "197681", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 41.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 NUCLEAR ANTIGEN ANTIBODY.3", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "197683", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 41.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 NUCLEAR ANTIGEN ANTIBODY.4", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "197685", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 41.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 NUCLEAR ANTIGEN ANTIBODY.8", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "199222", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 345.0, "discounted_cash": 69.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 NUCLEAR ANTIGEN ANTIBODY.9", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "197705", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 270.0, "discounted_cash": 54.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 RNP ANTIBODIES", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "164008", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 170.0, "discounted_cash": 34.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 SCLERODERMA 70 ABS", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "164012", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 208.0, "discounted_cash": 41.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 SMITH IGG ANTIBODIES", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "164010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 27.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 SSA 52 AND 60 ANTIBODY, IGG", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "259076", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 345.0, "discounted_cash": 69.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86235 SSB ENA ANTIBODY IGG", "code_information": [{"code": "86235", "type": "CPT"}, {"code": "259209", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 345.0, "discounted_cash": 69.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 ANCA", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "164014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 96.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 CASPR2 AB IGG", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "197723", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 96.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 DSDNA CRITHIDIA AB", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "164016", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 45.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 FLORESCENT NONINFECTIOUS AGENT ANTIBODY; SCREEN, EACH", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "191338", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 96.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 FLRSNT NONINFECTIOUS AB SCRN", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "197729", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 96.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 FLUORESCENT ANTIBODY, PAVAL", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "187460", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 96.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 GLOMERULAR BASE MEMB AB IGG", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "197707", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 22.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 MUSCLE-SPECIFIC KINASE ANTIBODY, IGG", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "259080", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 96.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 MYOCARDIAL AB IGG", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "197709", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 96.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 NEUROMYELITIS OPTICA IGG", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "197711", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 96.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 NMDA RECEPTOR AB IGG", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "197727", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 96.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 PLA2R ANTIBODY", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "197717", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 96.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 PURKINJE CELL ANNA IGG SCREEN", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "197719", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 484.0, "discounted_cash": 96.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86255 STRIATED MUSCLE AB IGG", "code_information": [{"code": "86255", "type": "CPT"}, {"code": "197715", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 22.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86256 DSDNA ANTIBODY, IGG", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "258570", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86256 ENDOMYSIAL AB TITER, S (IGA)", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "191346", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 108.0, "discounted_cash": 21.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86256 ENDOMYSIAL ANTIBODIES", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "164018", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 176.0, "discounted_cash": 35.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86256 FLUORESCENT AB TITER", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "197741", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86256 FLUORESCENT ANTIBODY, TITER", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "104948", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86256 FLUORESCENT ANTIBODY, TITER GABA-AR IGLON5, MGLUR1", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "298450", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 800.0, "discounted_cash": 160.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86256 FLUORESCENT NONINFECTIOUS AGENT ANTIBODY; TITER, EACH", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "191348", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86256 NEURONAL NUCLEAR ANTIBODIES HU", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "164020", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 63.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86256 PLA2R TITER REFLEX", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "197745", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 315.0, "discounted_cash": 63.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86256 SMOOTH MUSCLE AB TITER", "code_information": [{"code": "86256", "type": "CPT"}, {"code": "197735", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 48.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86258 DGP ANTIBODY EACH IG CLASS", "code_information": [{"code": "86258", "type": "CPT"}, {"code": "189552", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 9.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86258 GLIADIN AB EA IG CLASS", "code_information": [{"code": "86258", "type": "CPT"}, {"code": "197597", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 9.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86300 CA 27.29", "code_information": [{"code": "86300", "type": "CPT"}, {"code": "164022", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 40.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86300 IMMUNOASSAY, TUMOR, CA 15-3", "code_information": [{"code": "86300", "type": "CPT"}, {"code": "104950", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 322.0, "discounted_cash": 64.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86301 IMMUNOASSAY, TUMOR, CA 19-9", "code_information": [{"code": "86301", "type": "CPT"}, {"code": "104952", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 70.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86304 IMMUNOASSAY, TUMOR, CA 125", "code_information": [{"code": "86304", "type": "CPT"}, {"code": "104954", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 70.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86305 ROMA HE4", "code_information": [{"code": "86305", "type": "CPT"}, {"code": "191352", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 28.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86308 HETEROPHILE ANTIBODIES", "code_information": [{"code": "86308", "type": "CPT"}, {"code": "104956", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 41.0, "discounted_cash": 8.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86316 IMMUNOASSAY TUMOR ANTIGEN QUAN", "code_information": [{"code": "86316", "type": "CPT"}, {"code": "176521", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86316 NEURON SPECIFIC ENOLASE", "code_information": [{"code": "86316", "type": "CPT"}, {"code": "197753", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86317 IMMUNOASSAY FOR INFECTIOUS AGENT ANTIBODY, QUANTITATIVE", "code_information": [{"code": "86317", "type": "CPT"}, {"code": "191354", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 133.0, "discounted_cash": 26.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86328 IA INFECTIOUS AGT ANTIBODY SARS-COV-2 COVID-19", "code_information": [{"code": "86328", "type": "CPT"}, {"code": "227427", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 47.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86331 IMMUNODIFFUSION OUCHTERLONY", "code_information": [{"code": "86331", "type": "CPT"}, {"code": "104964", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 17.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86331 LAB HYPERSENS. FOR PNEUMONITIS", "code_information": [{"code": "86331", "type": "CPT"}, {"code": "105582", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1639.0, "discounted_cash": 327.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86334 IG-G SYNTHETIC RATE (CSF)", "code_information": [{"code": "86334", "type": "CPT"}, {"code": "164026", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 467.0, "discounted_cash": 93.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86334 IMMUNOFIX E-PHORESIS, SERUM", "code_information": [{"code": "86334", "type": "CPT"}, {"code": "104966", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 317.0, "discounted_cash": 63.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86334 IMMUNOFIXATION ELECTROPHORESIS", "code_information": [{"code": "86334", "type": "CPT"}, {"code": "258568", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 412.0, "discounted_cash": 82.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86335 BETA 2 TRANSFERRIN", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "164028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 666.0, "discounted_cash": 133.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86335 IMMUNFIX E-PHORSIS/URINE/CSF", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "104968", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 106.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86335 IMMUNFIX W CONC OTHER FLUIDS", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "197769", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 106.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86335 IMMUNOFIX W CONC OTH FLUIDS 2", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "197767", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 106.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86335 IMMUNOFIXATION 24HR URINE", "code_information": [{"code": "86335", "type": "CPT"}, {"code": "197771", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 106.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86336 INHIBIN A", "code_information": [{"code": "86336", "type": "CPT"}, {"code": "104970", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 121.0, "discounted_cash": 24.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86337 INSULIN ANTIBODIES", "code_information": [{"code": "86337", "type": "CPT"}, {"code": "104972", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 76.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86340 INTRINSIC FACTOR ANTIBODY", "code_information": [{"code": "86340", "type": "CPT"}, {"code": "104974", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 38.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86341 ENCEPHALOPATHY AUTOIMM PARANEO-MAYO", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "277334", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 39.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86341 ISLET CELL ANTIBODY", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "104976", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 39.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86341 ISLET CELL ANTIBODY", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "191358", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 39.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86341 ISLET CELL ANTIBODY.4", "code_information": [{"code": "86341", "type": "CPT"}, {"code": "197775", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 39.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86352 NEUTROPHIL OXIDATIVE BURST", "code_information": [{"code": "86352", "type": "CPT"}, {"code": "197777", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 719.0, "discounted_cash": 143.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86355 B CELLS TOTAL COUNT", "code_information": [{"code": "86355", "type": "CPT"}, {"code": "238739", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 66.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86356 FLOW CYTOMETRY", "code_information": [{"code": "86356", "type": "CPT"}, {"code": "197783", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 83.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86356 FLOW CYTOMETRY CD CELLS", "code_information": [{"code": "86356", "type": "CPT"}, {"code": "197791", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 83.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86356 HGB-F FETOMATERN HEMORRHAGE", "code_information": [{"code": "86356", "type": "CPT"}, {"code": "197787", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 47.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86356 MONONUCLEAR CELL ANTIGEN", "code_information": [{"code": "86356", "type": "CPT"}, {"code": "238741", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 47.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86357 NK CELLS TOTAL COUNT", "code_information": [{"code": "86357", "type": "CPT"}, {"code": "238743", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 66.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86359 CD4 COUNT", "code_information": [{"code": "86359", "type": "CPT"}, {"code": "212374", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 66.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86359 T CELLS TOTAL COUNT 2", "code_information": [{"code": "86359", "type": "CPT"}, {"code": "197795", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 334.0, "discounted_cash": 66.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86360 T CELL CD4 CD8 COUNT W RATIO 2", "code_information": [{"code": "86360", "type": "CPT"}, {"code": "197797", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 83.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86360 T CELLS; ABSOLUTE CD4 AND CD8 COUNT, INCLUDING RATIO", "code_information": [{"code": "86360", "type": "CPT"}, {"code": "191362", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 416.0, "discounted_cash": 83.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86361 T CELL, ABSOLUTE COUNT", "code_information": [{"code": "86361", "type": "CPT"}, {"code": "104980", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 70.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86362 MOG-IGG1 AB CBA", "code_information": [{"code": "86362", "type": "CPT"}, {"code": "197799", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 47.0, "discounted_cash": 9.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86363 MOG FACS, S", "code_information": [{"code": "86363", "type": "CPT"}, {"code": "197801", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 83.0, "discounted_cash": 16.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86364 TISS TRNSGLTMNASE EA IG CLAS", "code_information": [{"code": "86364", "type": "CPT"}, {"code": "189554", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 9.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86364 TISSUE TRANSGLUTAMINASE EA IG CLASS", "code_information": [{"code": "86364", "type": "CPT"}, {"code": "197601", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 9.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86366 MUSCLE-SPECIFIC KINASE AB", "code_information": [{"code": "86366", "type": "CPT"}, {"code": "293330", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 403.0, "discounted_cash": 80.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86376 MICROSOMAL ANTIBODY", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "104982", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 182.0, "discounted_cash": 36.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86376 MICROSOMAL ANTIBODY THYROID PR", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "197807", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 182.0, "discounted_cash": 36.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86376 MICROSOMAL ANTIBODY THYROID PR.2", "code_information": [{"code": "86376", "type": "CPT"}, {"code": "197811", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 182.0, "discounted_cash": 36.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86381 MITOCHONDRIAL AB EACH", "code_information": [{"code": "86381", "type": "CPT"}, {"code": "197605", "type": "CDM"}, {"code": "301", "type": "RC"}], "standard_charges": [{"gross_charge": 100.0, "discounted_cash": 20.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86382 NEUTRALIZATION TEST VIRAL", "code_information": [{"code": "86382", "type": "CPT"}, {"code": "238745", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 151.0, "discounted_cash": 30.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86403 PARTICLE AGGLUTINATION TEST", "code_information": [{"code": "86403", "type": "CPT"}, {"code": "104984", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 139.0, "discounted_cash": 27.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86406 AG, CRYPTOCOCCAL TITER ADD-ON", "code_information": [{"code": "86406", "type": "CPT"}, {"code": "191364", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 17.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86430 RHEUMATOID FACTOR TEST", "code_information": [{"code": "86430", "type": "CPT"}, {"code": "104986", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 18.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86431 RHEUMATOID FACTOR IGM QUANT", "code_information": [{"code": "86431", "type": "CPT"}, {"code": "197825", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 24.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86431 RHEUMATOID FACTOR, QUANT", "code_information": [{"code": "86431", "type": "CPT"}, {"code": "104988", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 18.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86480 TB TEST, CELL IMMUN MEASURE", "code_information": [{"code": "86480", "type": "CPT"}, {"code": "104990", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 460.0, "discounted_cash": 92.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86481 TB AG RESPONSE T-CELL SUSP", "code_information": [{"code": "86481", "type": "CPT"}, {"code": "184729", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 528.0, "discounted_cash": 105.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86580 TB INTRADERMAL TEST", "code_information": [{"code": "86580", "type": "CPT"}, {"code": "105000", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 71.0, "discounted_cash": 14.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86581 STRPTCS PNEUM ANTBDY IGG SEROTYPES IA QUAN", "code_information": [{"code": "86581", "type": "CPT"}, {"code": "358085", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 7.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86592 BLOOD SEROLOGY, QUALITATIVE", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "105006", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 80.0, "discounted_cash": 16.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86592 RPR CORD BLOOD", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "164040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 111.0, "discounted_cash": 22.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86592 SYPHILIS TEST QL VDRL", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "197829", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 30.0, "discounted_cash": 6.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86592 VDRL, SPINAL FLUID", "code_information": [{"code": "86592", "type": "CPT"}, {"code": "164036", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 18.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86593 BLOOD SEROLOGY, QUANTITATIVE", "code_information": [{"code": "86593", "type": "CPT"}, {"code": "105008", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 28.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86596 VOLTAGE-GATED CALCIUM CHANNEL ANTIBODY, PAVAL", "code_information": [{"code": "86596", "type": "CPT"}, {"code": "187458", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 213.0, "discounted_cash": 42.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86606 ASPERGILLUS ANTIBODY ID S", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "105010", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 27.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86606 ASPERGILLUS FUMIGATUS AB", "code_information": [{"code": "86606", "type": "CPT"}, {"code": "164042", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 135.0, "discounted_cash": 27.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86609 BACTERIUM ANTIBODY", "code_information": [{"code": "86609", "type": "CPT"}, {"code": "105012", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 19.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86611 BARTON QUINTANA", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "197833", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 668.0, "discounted_cash": 133.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86611 BARTONELLA ANTIBODY", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "105014", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 293.0, "discounted_cash": 58.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86611 BARTONELLA HENSELAE", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "197835", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 668.0, "discounted_cash": 133.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86611 LAB BARTONELLA IGG, IGM", "code_information": [{"code": "86611", "type": "CPT"}, {"code": "105568", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 514.0, "discounted_cash": 102.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86612 BLASTOMYCES ANTIBODY", "code_information": [{"code": "86612", "type": "CPT"}, {"code": "105016", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 248.0, "discounted_cash": 49.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86612 BLASTOMYCES ANTIBODY.2", "code_information": [{"code": "86612", "type": "CPT"}, {"code": "197837", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 248.0, "discounted_cash": 49.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86615 BORDETELLA ANTIBODY", "code_information": [{"code": "86615", "type": "CPT"}, {"code": "105018", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 302.0, "discounted_cash": 60.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86615 BORDETELLA PERTUSSIS AB IGG", "code_information": [{"code": "86615", "type": "CPT"}, {"code": "197841", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 302.0, "discounted_cash": 60.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86617 BORRELIA BURGDORFERI AB IGM", "code_information": [{"code": "86617", "type": "CPT"}, {"code": "197855", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 25.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86617 LYME DISEASE ANTIBODY", "code_information": [{"code": "86617", "type": "CPT"}, {"code": "105020", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 98.0, "discounted_cash": 19.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86618 LYME AB DETECTION BLD", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "197857", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 186.0, "discounted_cash": 37.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86618 LYME DISEASE ANTIBODY", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "105022", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 109.0, "discounted_cash": 21.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86618 LYME DISEASE TITER", "code_information": [{"code": "86618", "type": "CPT"}, {"code": "164046", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 48.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86622 BRUCELLA ANTIBODY", "code_information": [{"code": "86622", "type": "CPT"}, {"code": "105024", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 272.0, "discounted_cash": 54.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86622 BRUCELLA TOTAL AB CONF AGGLUTIN", "code_information": [{"code": "86622", "type": "CPT"}, {"code": "191374", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 272.0, "discounted_cash": 54.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86631 CHLAMYDIA ANTIBODY", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "105028", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 155.0, "discounted_cash": 31.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86631 CHLAMYDIA TRACHOMATIS IGG", "code_information": [{"code": "86631", "type": "CPT"}, {"code": "197863", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 155.0, "discounted_cash": 31.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86632 CHLAMYDIA IGM ANTIBODY", "code_information": [{"code": "86632", "type": "CPT"}, {"code": "105030", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 155.0, "discounted_cash": 31.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86635 COCCIDIOIDES AB CSF", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "191378", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 50.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86635 COCCIDIOIDES ANTIBODY", "code_information": [{"code": "86635", "type": "CPT"}, {"code": "105032", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 191.0, "discounted_cash": 38.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86638 COXIELLA BURNETII AB PHS", "code_information": [{"code": "86638", "type": "CPT"}, {"code": "197871", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 38.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86638 Q FEVER AB PHASE 1 IGG", "code_information": [{"code": "86638", "type": "CPT"}, {"code": "197873", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 38.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86638 Q FEVER ANTIBODY", "code_information": [{"code": "86638", "type": "CPT"}, {"code": "105034", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 38.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86641 CRYPTOCOCCUS ANTIBODY", "code_information": [{"code": "86641", "type": "CPT"}, {"code": "105036", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 43.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86644 CMV ANTIBODY.3", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "197877", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 28.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86644 CMV CMV ANTIBODY IGG", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "197875", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 28.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86644 CMV TITER", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "164052", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 167.0, "discounted_cash": 33.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86644 CMV, BLOOD UNIT SCREEN", "code_information": [{"code": "86644", "type": "CPT"}, {"code": "164054", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 139.0, "discounted_cash": 27.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86645 CMV ANTIBODY, IGM", "code_information": [{"code": "86645", "type": "CPT"}, {"code": "105040", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 167.0, "discounted_cash": 33.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86645 CYTOMEGALOVIRUS AB IGM", "code_information": [{"code": "86645", "type": "CPT"}, {"code": "191380", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 217.0, "discounted_cash": 43.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86651 CALIFORNIA IGM", "code_information": [{"code": "86651", "type": "CPT"}, {"code": "197879", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 23.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86651 ENCEPHALITIS ANTIBODY", "code_information": [{"code": "86651", "type": "CPT"}, {"code": "105042", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 15.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86652 ENCEPHALITIS ANTIBODY", "code_information": [{"code": "86652", "type": "CPT"}, {"code": "105044", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 15.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86652 ENCEPHALITIS ANTIBODY.2", "code_information": [{"code": "86652", "type": "CPT"}, {"code": "197885", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 23.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86653 ENCEPHALITIS ANTIBODY", "code_information": [{"code": "86653", "type": "CPT"}, {"code": "105046", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 15.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86653 ENCEPHALITIS ANTIBODY.3", "code_information": [{"code": "86653", "type": "CPT"}, {"code": "197893", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 23.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86654 ENCEPHALITIS ANTIBODY", "code_information": [{"code": "86654", "type": "CPT"}, {"code": "105048", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 77.0, "discounted_cash": 15.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86654 WESTERN IGM", "code_information": [{"code": "86654", "type": "CPT"}, {"code": "197901", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 23.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86658 COXSACKIE A ANTIBODIES", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "164056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 477.0, "discounted_cash": 95.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86658 COXSACKIE B ANTIBODIES", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "164058", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 611.0, "discounted_cash": 122.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86658 ENTEROVIRUS AB COXSACKIE B", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "197903", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 611.0, "discounted_cash": 122.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86658 ENTEROVIRUS ANTIBODY", "code_information": [{"code": "86658", "type": "CPT"}, {"code": "105050", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 456.0, "discounted_cash": 91.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86663 ANTIBDY EPSTEIN-BARR EB VIR EARLY ANTIGEN EA", "code_information": [{"code": "86663", "type": "CPT"}, {"code": "176523", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 328.0, "discounted_cash": 65.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86664 EPSTEIN-BARR ANTIBODY", "code_information": [{"code": "86664", "type": "CPT"}, {"code": "105054", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 26.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86665 EPSTEIN-BARR ANTIBODY", "code_information": [{"code": "86665", "type": "CPT"}, {"code": "105056", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 26.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86666 ANAPLASMA PHAGOCYTOPHILUM (HGA) ANTIBODY, IBG", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "250822", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 14.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86666 ANTIBODY; EHRLICHIA", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "191382", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 14.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86666 EHRLICHIA ANTIBODY.3", "code_information": [{"code": "86666", "type": "CPT"}, {"code": "197917", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 14.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86668 FRANCISELLA TULARENSIS AB, IGM IGG", "code_information": [{"code": "86668", "type": "CPT"}, {"code": "230827", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 94.0, "discounted_cash": 18.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86671 AVIAN PROTEIN", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "191384", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 20.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86671 FUNGUS ANTIBODY", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "105062", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 20.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86671 SACCAROMYCES CEREVISIAE AB IGG", "code_information": [{"code": "86671", "type": "CPT"}, {"code": "197921", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 20.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86677 HELICOBACTER PYLORI", "code_information": [{"code": "86677", "type": "CPT"}, {"code": "105064", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 107.0, "discounted_cash": 21.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86682 ANTIBODY; HELMINTH, NOT ELSEWHERE SPECIFIED", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "191386", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 14.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86682 CYSTICERCOSIS AB, IGG", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "191388", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 14.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86682 ECHINOCOCCUS AB IGG", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "197923", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 14.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86682 ECHINOCOCCUS AB IGG EIA W/REF WB-MAYO", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "191390", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 14.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86682 SCHISTOSOMA AB", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "197925", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 14.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86682 STRONGYLOIDES IGG AB", "code_information": [{"code": "86682", "type": "CPT"}, {"code": "197927", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 14.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86689 ANTIBODY; HTLV OR HIV ANTIBODY, CONFIRMATORY TEST", "code_information": [{"code": "86689", "type": "CPT"}, {"code": "191396", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 88.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86689 HTLV/HIV CONFIRMATORY TEST", "code_information": [{"code": "86689", "type": "CPT"}, {"code": "105066", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 88.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86692 HEPATITIS DELTA AB", "code_information": [{"code": "86692", "type": "CPT"}, {"code": "191398", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 36.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86694 HERPES SIMPLEX 1&2, IGM", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "164060", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 419.0, "discounted_cash": 83.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86694 HERPES SIMPLEX CSF", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "197937", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 545.0, "discounted_cash": 109.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86694 HERPES SIMPLEX TEST", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "105068", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 545.0, "discounted_cash": 109.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86694 HERPES SIMPLEX TEST.2", "code_information": [{"code": "86694", "type": "CPT"}, {"code": "197935", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 419.0, "discounted_cash": 83.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86695 HERPES SIMPLEX TEST", "code_information": [{"code": "86695", "type": "CPT"}, {"code": "105070", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 200.0, "discounted_cash": 40.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86695 HSV1 IGG", "code_information": [{"code": "86695", "type": "CPT"}, {"code": "191400", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 263.0, "discounted_cash": 52.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86696 HERPES SIMPLEX TYPE 2", "code_information": [{"code": "86696", "type": "CPT"}, {"code": "105072", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 200.0, "discounted_cash": 40.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86696 HSV2 IGG", "code_information": [{"code": "86696", "type": "CPT"}, {"code": "191402", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 263.0, "discounted_cash": 52.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86698 HISTOPLASMA", "code_information": [{"code": "86698", "type": "CPT"}, {"code": "105074", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 32.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86698 HISTOPLASMA.2", "code_information": [{"code": "86698", "type": "CPT"}, {"code": "197943", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 32.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86701 HIV-1", "code_information": [{"code": "86701", "type": "CPT"}, {"code": "105076", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 59.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86702 ANTIBODY HIV-2", "code_information": [{"code": "86702", "type": "CPT"}, {"code": "176525", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 16.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86703 HIV-1/HIV-2, SINGLE ASSAY", "code_information": [{"code": "86703", "type": "CPT"}, {"code": "105078", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 59.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86704 HEP B CORE ANTIBODY, TOTAL", "code_information": [{"code": "86704", "type": "CPT"}, {"code": "105080", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 151.0, "discounted_cash": 30.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86705 HEP B CORE ANTIBODY, IGM", "code_information": [{"code": "86705", "type": "CPT"}, {"code": "105082", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 130.0, "discounted_cash": 26.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86706 HEP B SURFACE ANTIBODY", "code_information": [{"code": "86706", "type": "CPT"}, {"code": "105084", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 147.0, "discounted_cash": 29.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86707 HEP BE ANTIBODY", "code_information": [{"code": "86707", "type": "CPT"}, {"code": "105086", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 151.0, "discounted_cash": 30.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86708 HEP A ANTIBODY", "code_information": [{"code": "86708", "type": "CPT"}, {"code": "105088", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 44.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86709 HEP A ANTIBODY, IGM", "code_information": [{"code": "86709", "type": "CPT"}, {"code": "105090", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 200.0, "discounted_cash": 40.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86710 INFLUENZA VIRUS ANTIBODY", "code_information": [{"code": "86710", "type": "CPT"}, {"code": "238751", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 14.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86711 ANTIBODY JOHN CUNNINGHAM VIRUS", "code_information": [{"code": "86711", "type": "CPT"}, {"code": "289245", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 23.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86713 LEGIONELLA AB IGG", 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"type": "RC"}], "standard_charges": [{"gross_charge": 273.0, "discounted_cash": 54.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86735 MUMPS ANTIBODY", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "105098", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 21.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86735 MUMPS, AB-IGG", "code_information": [{"code": "86735", "type": "CPT"}, {"code": "164064", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 21.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86738 MYCOPLASMA ANTIBODY", "code_information": [{"code": "86738", "type": "CPT"}, {"code": "105100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 46.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86747 PARVOVIRUS ANTIBODY", "code_information": [{"code": "86747", "type": "CPT"}, {"code": "105102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 44.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86753 AMEBIASIS E HISTOLYTICA AB", "code_information": [{"code": "86753", "type": "CPT"}, {"code": "197975", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 57.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86753 AMOEBA ANTIBODY TITER", "code_information": [{"code": "86753", "type": "CPT"}, {"code": "164066", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 57.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86753 BABESIA MICROTI ANTIBODY, IBG BY IFA", 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"CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 32.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86757 TYPHUS RICKETTSIA AB IGG", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "197983", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 32.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86757 TYPHUS RICKETTSIA AB IGM", "code_information": [{"code": "86757", "type": "CPT"}, {"code": "197985", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 32.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86762 RUBELLA ANTIBODY", "code_information": [{"code": "86762", "type": "CPT"}, {"code": "105108", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 172.0, 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"300", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 50.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86880 DIRECT COOMBS C3", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "199018", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 50.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86880 DIRECT COOMBS POLY", "code_information": [{"code": "86880", "type": "CPT"}, {"code": "199020", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 50.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86886 COOMBS TEST, INDIRECT, TITER", "code_information": [{"code": "86886", "type": "CPT"}, {"code": "105146", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 267.0, "discounted_cash": 53.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86890 AUTOLOGOUS BLOOD PROCESS", "code_information": [{"code": "86890", "type": "CPT"}, {"code": "105148", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1457.0, "discounted_cash": 291.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86900 BLOOD TYPING, ABO", "code_information": [{"code": "86900", "type": "CPT"}, {"code": "105150", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 442.0, "discounted_cash": 88.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86901 BLOOD TYPING, RH (D)", "code_information": [{"code": "86901", "type": "CPT"}, {"code": "105152", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 27.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86902 ANTIGEN TEST UNIT EA AG TEST", 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{"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 30.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86905 BLOOD TYPING, RBC ANTIGENS", "code_information": [{"code": "86905", "type": "CPT"}, {"code": "105158", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 30.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86920 CROSSMATCH, IS", "code_information": [{"code": "86920", "type": "CPT"}, {"code": "164102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 116.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86921 CROSSMATCH INCUBAT", "code_information": [{"code": "86921", "type": "CPT"}, {"code": "199030", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 582.0, "discounted_cash": 116.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86922 COMPATIBILITY TEST, ANTIGLOB", "code_information": [{"code": "86922", "type": "CPT"}, {"code": "105164", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 339.0, "discounted_cash": 67.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86923 ELECTRONIC CROSSMATCH", "code_information": [{"code": "86923", "type": "CPT"}, {"code": "191424", "type": "CDM"}, {"code": "302", "type": "RC"}], "standard_charges": [{"gross_charge": 546.0, "discounted_cash": 109.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86940 ISOAGGLUTININ TITER", "code_information": [{"code": "86940", "type": "CPT"}, {"code": "164108", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 344.0, "discounted_cash": 68.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86941 HEMOLYSINS & AGGLUTININS INCUBATED", "code_information": [{"code": "86941", "type": "CPT"}, {"code": "258269", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 439.0, "discounted_cash": 87.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86945 BLOOD PRODUCT/IRRADIATION", "code_information": [{"code": "86945", "type": "CPT"}, {"code": "105174", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1021.0, "discounted_cash": 204.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86970 NEUTRALIZATION", "code_information": [{"code": "86970", "type": "CPT"}, {"code": "164110", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 214.0, "discounted_cash": 42.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86971 RBC PRETX INCUBATJ W/ENZYMES, EA", "code_information": [{"code": "86971", "type": "CPT"}, {"code": "184578", "type": "CDM"}, {"code": "390", "type": "RC"}], "standard_charges": [{"gross_charge": 625.0, "discounted_cash": 125.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86972 RBC PRETX INCUBATJ W/DENSITY", "code_information": [{"code": "86972", "type": "CPT"}, {"code": "184580", "type": "CDM"}, {"code": "390", "type": "RC"}], "standard_charges": [{"gross_charge": 358.0, "discounted_cash": 71.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86978 RBC PRETREATMENT, SERUM", "code_information": [{"code": "86978", "type": "CPT"}, {"code": "105180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 78.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86978 WARM AUTOABSORPTION", "code_information": [{"code": "86978", "type": "CPT"}, {"code": "164114", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 779.0, "discounted_cash": 155.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 86985 SPLIT BLOOD OR PRODUCTS", "code_information": [{"code": "86985", "type": "CPT"}, {"code": "105182", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 182.0, "discounted_cash": 36.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87015 AFB ISOLATION REF", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "198129", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 56.0, "discounted_cash": 11.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87015 CONCENT FOR INFECT AGENT AFB", "code_information": [{"code": "87015", "type": "CPT"}, {"code": "198127", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 56.0, "discounted_cash": 11.2, "setting": "outpatient", "billing_class": "facility"}]}, 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"type": "CPT"}, {"code": "105190", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 106.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87046 CULTURE STOOL E. 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"outpatient", "billing_class": "facility"}]}, {"description": "HC 87076 CULTURE ANAEROBE IDENT, EACH", "code_information": [{"code": "87076", "type": "CPT"}, {"code": "105200", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 279.0, "discounted_cash": 55.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87077 BACTERIAL IDENTIFICATION", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "198153", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 272.0, "discounted_cash": 54.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87077 CULTURE AEROBIC IDENTIFY", "code_information": [{"code": "87077", "type": "CPT"}, {"code": "105202", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 272.0, "discounted_cash": 54.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87081 CUL PRSMPTV PTHGNC ORGNISM SCRN ONLY", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "296006", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 56.0, "discounted_cash": 11.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87081 CULTURE SCREEN ONLY", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "198177", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 56.0, "discounted_cash": 11.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87081 CULTURE VIBRIO", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "198169", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 8.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87081 CULTURE, GC (GONOCOCCAL)", "code_information": [{"code": "87081", "type": "CPT"}, {"code": "191430", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 56.0, "discounted_cash": 11.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87086 URINE CULTURE/COLONY COUNT", "code_information": [{"code": "87086", "type": "CPT"}, {"code": "105206", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 450.0, "discounted_cash": 90.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87088 URINE BACTERIA CULTURE", "code_information": [{"code": "87088", "type": "CPT"}, {"code": "105208", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 49.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87101 FUNGAL CULT & SMEAR SKIN & NAI", "code_information": [{"code": "87101", "type": "CPT"}, {"code": "212376", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 13.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87102 FUNGUS ISOLATION CULTURE", "code_information": [{"code": "87102", "type": "CPT"}, {"code": "105210", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 566.0, "discounted_cash": 113.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87103 BLOOD FUNGUS CULTURE", "code_information": [{"code": "87103", "type": "CPT"}, {"code": "105212", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 566.0, "discounted_cash": 113.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87106 CULTURE, FUNGI, DEFINITIVE ID, EA ORGNSM; YEAST", "code_information": [{"code": "87106", "type": "CPT"}, {"code": "182455", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 242.0, "discounted_cash": 48.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87107 FUNGI IDENTIFICATION, MOLD", "code_information": [{"code": "87107", "type": "CPT"}, {"code": "105214", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 459.0, "discounted_cash": 91.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87109 MYCOPLASMA", "code_information": [{"code": "87109", "type": "CPT"}, {"code": "238765", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 17.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87110 CHLAMYDIA CULTURE", "code_information": [{"code": "87110", "type": "CPT"}, {"code": "105216", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1040.0, "discounted_cash": 208.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87116 CULTURE AFB OTHER", "code_information": [{"code": "87116", "type": "CPT"}, {"code": "295980", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 91.0, "discounted_cash": 18.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87116 CULTURE MYCOBACTERIA", "code_information": [{"code": "87116", "type": "CPT"}, {"code": "198179", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 91.0, "discounted_cash": 18.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87118 MYCOBACTERIC IDENTIFICATION", "code_information": [{"code": "87118", "type": "CPT"}, {"code": "105218", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 591.0, "discounted_cash": 118.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87140 CHLAMYDIA STAIN", "code_information": [{"code": "87140", "type": "CPT"}, {"code": "212378", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": 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{"description": "HC 87147 HAEMOPHILUS TYPE B CSF", "code_information": [{"code": "87147", "type": "CPT"}, {"code": "164144", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 370.0, "discounted_cash": 74.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87147 MENINGITIS LATEX", "code_information": [{"code": "87147", "type": "CPT"}, {"code": "164146", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1334.0, "discounted_cash": 266.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87147 SHIGELLA TYP", "code_information": [{"code": "87147", "type": "CPT"}, {"code": "164142", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 310.0, "discounted_cash": 62.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87147 TYPING SALMONELLA", "code_information": [{"code": "87147", "type": "CPT"}, {"code": "296026", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 49.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87149 DNA/RNA DIRECT PROBE", "code_information": [{"code": "87149", "type": "CPT"}, {"code": "191434", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 33.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87150 CULTURE TYPING BY NUCLEIC ACID PROBE", "code_information": [{"code": "87150", "type": "CPT"}, {"code": "198191", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 58.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87150 ID, MTB SPECIATION, PCR", "code_information": [{"code": "87150", "type": "CPT"}, {"code": "191436", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 58.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87150 MYCOBACTERIA PROBE IDENT BROTH", "code_information": [{"code": "87150", "type": "CPT"}, {"code": "191438", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 58.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87153 AFB IDENTIFICATION BY SEQUENCING", "code_information": [{"code": "87153", "type": "CPT"}, {"code": "259070", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 950.0, "discounted_cash": 190.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87153 ID BY 16S SEQUENCING", "code_information": [{"code": "87153", "type": "CPT"}, {"code": "191440", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 950.0, "discounted_cash": 190.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87154 CULTURE BLOOD >=6 TARGETS", "code_information": [{"code": "87154", "type": "CPT"}, {"code": "257450", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1154.0, "discounted_cash": 230.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87158 AFB IDENTIFICATION MALDI", "code_information": [{"code": "87158", "type": "CPT"}, {"code": "260257", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 68.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87158 CULTURE TYPING OTHER METHODS", "code_information": [{"code": "87158", "type": "CPT"}, {"code": "227347", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 340.0, "discounted_cash": 68.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87169 PARASITE IDENTIFICATION, GROSS", "code_information": [{"code": "87169", "type": "CPT"}, {"code": "191442", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 36.0, "discounted_cash": 7.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87172 PINWORM EXAM", "code_information": [{"code": "87172", "type": "CPT"}, {"code": "105222", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 228.0, "discounted_cash": 45.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87176 TISSUE HOMOGENIZATION, CULTR", "code_information": [{"code": "87176", "type": "CPT"}, {"code": "105224", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 52.0, "discounted_cash": 10.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87177 OVA AND PARASITES SMEARS", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "105226", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 358.0, "discounted_cash": 71.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87181 ANTIMICROBIAL SUSCEPTIBILITY ANAEROBIC MIC", "code_information": [{"code": "87181", "type": "CPT"}, {"code": "191444", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 119.0, "discounted_cash": 23.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87181 SUSCEPTIBIL SNGL DRUG BY ETEST", "code_information": [{"code": "87181", "type": "CPT"}, {"code": "198199", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 119.0, "discounted_cash": 23.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87181 SUSCEPTIBILITY GRADIENT STRIP", "code_information": [{"code": "87181", "type": "CPT"}, {"code": "198207", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 119.0, "discounted_cash": 23.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87184 MICRO DISC DIFFUSION ID", "code_information": [{"code": "87184", "type": "CPT"}, {"code": "164148", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 262.0, "discounted_cash": 52.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87184 MICROBE SUSCEPTIBLE, DISK", "code_information": [{"code": "87184", "type": "CPT"}, {"code": "105228", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 100.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87184 SUSCEPT DISK PER PLATE 12 OR L", "code_information": [{"code": "87184", "type": "CPT"}, {"code": "198225", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 100.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87185 MICROBE SUSCEPTIBLE, ENZYME", "code_information": [{"code": "87185", "type": "CPT"}, {"code": "105230", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 212.0, "discounted_cash": 42.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87186 AFB/NOCARDIA BY BROTH DILUTION", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "198227", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87186 MICROBE SUSCEPTIBLE, MIC", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "105232", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87186 SUSCEPTIBLE MIC PER PLATE", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "198229", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 482.0, "discounted_cash": 96.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87187 MICROBE SUSCEPTIBLE MLC EACH PLATE", "code_information": [{"code": "87187", "type": "CPT"}, {"code": "191343", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 27.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87188 MICROBE SUSCEPT, MACROBROTH", "code_information": [{"code": "87188", "type": "CPT"}, {"code": "105234", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 509.0, "discounted_cash": 101.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87205 FUNGUS SMEAR", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "164150", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 49.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87205 GC SMEAR", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "164154", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 243.0, "discounted_cash": 48.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87205 GRAM STAIN, QUANTITATIVE", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "164156", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 501.0, "discounted_cash": 100.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87205 SMEAR, GRAM STAIN", "code_information": [{"code": "87205", "type": "CPT"}, {"code": "105240", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 246.0, "discounted_cash": 49.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87206 CRYPTOSPORIDIUM STAIN", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "164158", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 88.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87206 SMEAR, FLUORESCENT/ACID STAI", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "105242", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 54.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87206 STAIN AFB", "code_information": [{"code": "87206", "type": "CPT"}, {"code": "295966", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 271.0, "discounted_cash": 54.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87207 MALARIA SMEAR", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "198233", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 62.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87207 SMEAR, SPECIAL STAIN", "code_information": [{"code": "87207", "type": "CPT"}, {"code": "105244", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 62.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87209 SMEAR, COMPLEX STAIN FOR OVA AND PARASITES", "code_information": [{"code": "87209", "type": "CPT"}, {"code": "105246", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 207.0, "discounted_cash": 41.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87210 INDIA INK PREP (CSF)", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "164164", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 206.0, "discounted_cash": 41.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87210 SMEAR, WET MOUNT, SALINE/INK", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "105248", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 5.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87210 WET MOUNT SMEAR", "code_information": [{"code": "87210", "type": "CPT"}, {"code": "164162", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 194.0, "discounted_cash": 38.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87220 TISSUE EXAM FOR FUNGI", "code_information": [{"code": "87220", "type": "CPT"}, {"code": "105250", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 29.0, "discounted_cash": 5.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87230 ASSAY, TOXIN OR ANTITOXIN", "code_information": [{"code": "87230", "type": "CPT"}, {"code": "178548", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 25.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87252 CMV CULTURE", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "164168", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1597.0, "discounted_cash": 319.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87252 HERPES CULTURE", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "164166", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1164.0, "discounted_cash": 232.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87252 VIRAL CULTURE", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "198239", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 228.0, "discounted_cash": 45.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87252 VIRUS INOCULATION, TISSUE", "code_information": [{"code": "87252", "type": "CPT"}, {"code": "105254", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1605.0, "discounted_cash": 321.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87253 HERPES CULTURE STAIN", "code_information": [{"code": "87253", "type": "CPT"}, {"code": "212380", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 28.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87254 VIRUS INOCULATION, SHELL VIA", "code_information": [{"code": "87254", "type": "CPT"}, {"code": "105256", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 34.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87255 CULTURE VIRAL HERPES", "code_information": [{"code": "87255", "type": "CPT"}, {"code": "295988", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 43.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87265 PERTUSSIS AG, IF", "code_information": [{"code": "87265", "type": "CPT"}, {"code": "105260", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 20.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87278 LEGION PNEUMOPHILIA AG, IF", "code_information": [{"code": "87278", "type": "CPT"}, {"code": "105268", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1049.0, "discounted_cash": 209.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87281 PNEUMOCYSTIS CARINII, AG, IF", "code_information": [{"code": "87281", "type": "CPT"}, {"code": "105272", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 941.0, "discounted_cash": 188.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87300 AG DETECTION, POLYVAL, IF", "code_information": [{"code": "87300", "type": "CPT"}, {"code": "105276", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 350.0, "discounted_cash": 70.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87305 ASPERGILLUS AG EIA", "code_information": [{"code": "87305", "type": "CPT"}, {"code": "176459", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 515.0, "discounted_cash": 103.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87324 CLOSTRIDIUM AG, EIA", "code_information": [{"code": "87324", "type": "CPT"}, {"code": "105278", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 762.0, "discounted_cash": 152.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87328 IAAD IA CRYPTOSPORIDIUM", "code_information": [{"code": "87328", "type": "CPT"}, {"code": "176529", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 251.0, "discounted_cash": 50.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87329 GIARDIA AG, EIA", "code_information": [{"code": "87329", "type": "CPT"}, {"code": "105280", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 495.0, "discounted_cash": 99.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87337 E HISTOLYTICA AG", "code_information": [{"code": "87337", "type": "CPT"}, {"code": "196325", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 78.0, "discounted_cash": 15.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87338 HPYLORI, STOOL, EIA", "code_information": [{"code": "87338", "type": "CPT"}, {"code": "105282", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 524.0, "discounted_cash": 104.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87340 HEPATITIS B SURFACE AG, EIA", "code_information": [{"code": "87340", "type": "CPT"}, {"code": "105286", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 664.0, "discounted_cash": 132.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87341 HEPATITIS B SURFACE, AG, EIA", "code_information": [{"code": "87341", "type": "CPT"}, {"code": "105288", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 371.0, "discounted_cash": 74.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87350 HEPATITIS BE AG, EIA", "code_information": [{"code": "87350", "type": "CPT"}, {"code": "105290", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 435.0, "discounted_cash": 87.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87385 HISTOPLASMA ANTIGEN, UR", "code_information": [{"code": "87385", "type": "CPT"}, {"code": "191448", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 20.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87385 HISTOPLASMIN ANTIGEN", "code_information": [{"code": "87385", "type": "CPT"}, {"code": "198255", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 101.0, "discounted_cash": 20.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87389 HIV1 AG WITH HIV1 AND HIV2 AB, S", "code_information": [{"code": "87389", "type": "CPT"}, {"code": "244222", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 25.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87389 HIV1 AND HIV2 AG AND AB EVAL, S", "code_information": [{"code": "87389", "type": "CPT"}, {"code": "191450", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 25.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87390 IAAD IA HIV-1", "code_information": [{"code": "87390", "type": "CPT"}, {"code": "243599", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 120.0, "discounted_cash": 24.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87391 IAAD IA HIV-1", "code_information": [{"code": "87391", "type": "CPT"}, {"code": "243601", "type": "CDM"}, 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"discounted_cash": 37.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87427 SHIGA-LIKE TOXIN 1", "code_information": [{"code": "87427", "type": "CPT"}, {"code": "177527", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 29.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87427 SHIGA-LIKE TOXIN 2", "code_information": [{"code": "87427", "type": "CPT"}, {"code": "177529", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 29.8, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "59"}, {"description": "HC 87428 IAAD IA SARS COVID & INFLUENZA VIRUS A&B", "code_information": [{"code": "87428", "type": "CPT"}, {"code": "230818", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 58.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87430 STREP A AG, EIA", "code_information": [{"code": "87430", "type": "CPT"}, {"code": "105296", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 368.0, "discounted_cash": 73.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87449 AG DETECT NOS, EIA, MULT", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "105298", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 642.0, "discounted_cash": 128.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87449 C DIFFICILE AG IA", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "198259", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 779.0, "discounted_cash": 155.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87449 LEGIONELLA AG, URIN", "code_information": [{"code": "87449", "type": "CPT"}, {"code": "164172", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 807.0, "discounted_cash": 161.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87467 HEPATITIS B SURFACE ANTIGEN QUANTITATIVE", "code_information": [{"code": "87467", "type": "CPT"}, {"code": "387261", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 419.0, "discounted_cash": 83.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87468 IADNA ANAPLASMA PHAGOCYTOPHILUM AMPLIFED PRB TQ", "code_information": [{"code": "87468", "type": "CPT"}, {"code": "249450", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 25.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87469 IADNA BABESIA MICROTI AMPLIFIED PROBE TQ", "code_information": [{"code": "87469", "type": "CPT"}, {"code": "249454", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 129.0, "discounted_cash": 25.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87471 BARTONELLA HENSALAE/QUINTANA DNA/RNA PCR", "code_information": [{"code": "87471", "type": "CPT"}, {"code": "198261", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 307.0, "discounted_cash": 61.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87476 LYME DIS, DNA, AMP PROBE", "code_information": [{"code": "87476", "type": "CPT"}, {"code": "105300", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1297.0, "discounted_cash": 259.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87483 CNS DNA AMP PROBE TYPE 12-25", "code_information": [{"code": "87483", "type": "CPT"}, {"code": "238781", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": 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"outpatient", "billing_class": "facility"}]}, {"description": "HC 87493 CLOSTRIDIUM DIFFICILE, PCR", "code_information": [{"code": "87493", "type": "CPT"}, {"code": "177351", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 382.0, "discounted_cash": 76.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87496 CYTOMEG, DNA, AMP PROBE", "code_information": [{"code": "87496", "type": "CPT"}, {"code": "105306", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1140.0, "discounted_cash": 228.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87496 CYTOMEGALOVIRUS PCR SALIVA ARUP", "code_information": [{"code": "87496", "type": "CPT"}, {"code": "258986", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 22.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87497 CMV DNA 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"238785", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 745.0, "discounted_cash": 149.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87505 NFCT AGENT DNA/RNA GI PATHOGEN", "code_information": [{"code": "87505", "type": "CPT"}, {"code": "177633", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 1057.0, "discounted_cash": 211.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87507 IADNA-DNA/RNA GI PTHGN MULTIPLEX PROBE TQ 12-2", "code_information": [{"code": "87507", "type": "CPT"}, {"code": "177637", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 3432.0, "discounted_cash": 686.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87517 HEPATITIS B RNA RT PCR QUANT", "code_information": [{"code": "87517", "type": "CPT"}, {"code": "198273", "type": "CDM"}, {"code": "306", "type": "RC"}], 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{"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 226.0, "discounted_cash": 45.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87551 MYCOBACTERIA, DNA, AMP PROBE", "code_information": [{"code": "87551", "type": "CPT"}, {"code": "105348", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 485.0, "discounted_cash": 97.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87556 M TUBERCULOSIS DETECTION PCR", "code_information": [{"code": "87556", "type": "CPT"}, {"code": "198289", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 1164.0, "discounted_cash": 232.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87556 M.TUBERCULO, DNA, AMP PROBE", "code_information": [{"code": "87556", "type": "CPT"}, {"code": "105352", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1164.0, "discounted_cash": 232.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87563 MYCOPLASMA GENITALIUM PCR", "code_information": [{"code": "87563", "type": "CPT"}, {"code": "198291", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 46.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87564 MTB RIFAMPIN RESISTANCE AMP PRB TQ", "code_information": [{"code": "87564", "type": "CPT"}, {"code": "358081", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 168.0, "discounted_cash": 33.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87581 M.PNEUMON, DNA, AMP PROBE", "code_information": [{"code": "87581", "type": "CPT"}, {"code": "105360", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 307.0, "discounted_cash": 61.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87591 N.GONORRHOEAE, DNA, AMP PROB", "code_information": [{"code": "87591", "type": "CPT"}, {"code": "105364", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 532.0, "discounted_cash": 106.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87594 PNEUMCYSTS JIROVECII AMP PRB TQ", "code_information": [{"code": "87594", "type": "CPT"}, {"code": "358083", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 197.0, "discounted_cash": 39.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87624 HPV, DNA, AMP PROBE", "code_information": [{"code": "87624", "type": "CPT"}, {"code": "105366", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 675.0, "discounted_cash": 135.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87624 HPV,AMP PROBE DNA", "code_information": [{"code": "87624", "type": "CPT"}, {"code": "164174", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 505.0, "discounted_cash": 101.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87625 HPV DNA/RNA TYPES 16 & 18 W/WO 45", "code_information": [{"code": "87625", "type": "CPT"}, {"code": "181994", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 392.0, "discounted_cash": 78.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87626 HPV SEP HI-RSK TYP&POOL RSLT", "code_information": [{"code": "87626", "type": "CPT"}, {"code": "358079", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 14.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87631 INFLU A,B PCR NASOPH", "code_information": [{"code": "87631", "type": "CPT"}, {"code": "191456", "type": "CDM"}, {"code": "306", "type": "RC"}], 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"discounted_cash": 197.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87798 EPSTEIN BARR DNA PCR QL", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "164180", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 987.0, "discounted_cash": 197.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87798 GENITALIUM MACROLIDE RESISTANCE", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "260346", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 46.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87798 HISTP-AG PCR", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "192267", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 987.0, "discounted_cash": 197.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": 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"discounted_cash": 304.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87798 WEST NILE PCR", "code_information": [{"code": "87798", "type": "CPT"}, {"code": "198333", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 1347.0, "discounted_cash": 269.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87799 BK VIRUS DNA QUANT RT PCR", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "198339", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 1414.0, "discounted_cash": 282.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87799 DETECT AGENT NOS, DNA, QUANT", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "105378", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1414.0, "discounted_cash": 282.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87799 EBV QN", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "198341", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 1414.0, "discounted_cash": 282.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87799 EPSTEIN BARR DNA PCR QN", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "164182", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1142.0, "discounted_cash": 228.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87799 INF AGENT NUC ACID QN", "code_information": [{"code": "87799", "type": "CPT"}, {"code": "198343", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 1414.0, "discounted_cash": 282.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87801 DETECT AGNT MULT, DNA, AMPLI", "code_information": [{"code": "87801", "type": "CPT"}, {"code": "105380", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 1005.0, "discounted_cash": 201.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87802 STREP B ASSAY W/OPTIC", "code_information": [{"code": "87802", "type": "CPT"}, {"code": "105382", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 629.0, "discounted_cash": 125.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87804 INFLUENZA A ANTIGEN", "code_information": [{"code": "87804", "type": "CPT"}, {"code": "202799", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 444.0, "discounted_cash": 88.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87804 INFLUENZA ASSAY W/OPTIC", "code_information": [{"code": "87804", "type": "CPT"}, {"code": "105384", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": 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"discounted_cash": 29.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87880 STREP A ASSAY W/OPTIC", "code_information": [{"code": "87880", "type": "CPT"}, {"code": "105386", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 72.0, "discounted_cash": 14.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87899 CAMPYLOBACTER AG", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "177531", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 29.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87899 INF AGENT ASSAY W/OPTIC, NOS", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "188829", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 29.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87899 SHIGA TOXIN OPT", "code_information": [{"code": "87899", "type": "CPT"}, {"code": "198369", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 149.0, "discounted_cash": 29.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87900 PHENOTYPE PREDICTION", "code_information": [{"code": "87900", "type": "CPT"}, {"code": "198373", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 1141.0, "discounted_cash": 228.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87901 HIV-1 GENOTYPIC INHIBITOR DRUG RESIST, P", "code_information": [{"code": "87901", "type": "CPT"}, {"code": "191460", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 1603.0, "discounted_cash": 320.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87902 GENOTYPE DNA/RNA HEPATITIS C", "code_information": [{"code": "87902", "type": "CPT"}, {"code": "105388", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 2730.0, "discounted_cash": 546.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87902 HEP C GENO", "code_information": [{"code": "87902", "type": "CPT"}, {"code": "191468", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 2762.0, "discounted_cash": 552.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87903 PHENOTYPE DNA HIV W/CULTURE", "code_information": [{"code": "87903", "type": "CPT"}, {"code": "238801", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": [{"gross_charge": 1523.0, "discounted_cash": 304.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 87904 HIV PHENOTYPE EA ADDL DRUG", "code_information": [{"code": "87904", "type": "CPT"}, {"code": "198375", "type": "CDM"}, {"code": "306", "type": "RC"}], "standard_charges": 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"setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88175 THIN PREP PAP IMAGER", "code_information": [{"code": "88175", "type": "CPT"}, {"code": "191472", "type": "CDM"}, {"code": "311", "type": "RC"}], "standard_charges": [{"gross_charge": 234.0, "discounted_cash": 46.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88177 CYTOPATH FNA, EA ADD ADEQ CK", "code_information": [{"code": "88177", "type": "CPT"}, {"code": "166134", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 87.0, "discounted_cash": 17.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88184 FLOW CYTOMETRY, 1ST MARKER", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "164206", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 31.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88184 FLOWCYTOMETRY/ TC, 1 MARKER", "code_information": [{"code": "88184", "type": "CPT"}, {"code": "105434", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 31.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88185 FLOW CYTOMETRY, EACH AD MARKER", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "164208", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 32.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88185 FLOWCYTOMETRY ADDL MRK 15/30", "code_information": [{"code": "88185", "type": "CPT"}, {"code": "198690", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 32.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88230 CHROMOSOME TISS CUL PB", "code_information": [{"code": "88230", "type": "CPT"}, {"code": "212386", "type": "CDM"}, {"code": "311", "type": "RC"}], "standard_charges": [{"gross_charge": 796.0, "discounted_cash": 159.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88230 LYMPHOCYTE TISSUE CULTURE", "code_information": [{"code": "88230", "type": "CPT"}, {"code": "198694", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 791.0, "discounted_cash": 158.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88230 TISSUE CULTURE NON NEOPLAS BLD", "code_information": [{"code": "88230", "type": "CPT"}, {"code": "198696", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 791.0, "discounted_cash": 158.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88233 CHROMOSOMES, POC FETAL LOSS", "code_information": [{"code": "88233", "type": "CPT"}, {"code": "202064", "type": "CDM"}, {"code": "311", "type": "RC"}], "standard_charges": [{"gross_charge": 745.0, "discounted_cash": 149.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88233 TISSUE CULTURE NON NEOPLAS POC", "code_information": [{"code": "88233", "type": "CPT"}, {"code": "198700", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 745.0, "discounted_cash": 149.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88237 CULTURE, NEOPLASTIC, BM/BLD", "code_information": [{"code": "88237", "type": "CPT"}, {"code": "164216", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1051.0, "discounted_cash": 210.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88237 TISSUE CULTURE, BONE MARROW", "code_information": [{"code": "88237", "type": "CPT"}, {"code": "105444", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1063.0, "discounted_cash": 212.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88239 TISSUE CULTURE TUMOR", "code_information": [{"code": "88239", "type": "CPT"}, {"code": "238805", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 781.0, "discounted_cash": 156.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88248 CHROMOSOME ANALYSIS, 50-100", "code_information": [{"code": "88248", "type": "CPT"}, {"code": "105446", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 6579.0, "discounted_cash": 1315.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88261 CHROMOSOME ANALYSIS, 5", "code_information": [{"code": "88261", "type": "CPT"}, {"code": "105448", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 6029.0, "discounted_cash": 1205.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88262 BCCHPOC CHROMOSOME POC 15-20", "code_information": [{"code": "88262", "type": "CPT"}, {"code": "212397", "type": "CDM"}, {"code": "311", "type": "RC"}], "standard_charges": [{"gross_charge": 846.0, "discounted_cash": 169.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88262 CHROMO ANLY 15 TO 20 2K W BND4", "code_information": [{"code": "88262", "type": "CPT"}, {"code": "198704", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 846.0, "discounted_cash": 169.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88262 CHROMOSOME ANAL:15-20,2 KARYOTYPES", "code_information": [{"code": "88262", "type": "CPT"}, {"code": "212388", "type": "CDM"}, {"code": "311", "type": "RC"}], "standard_charges": [{"gross_charge": 846.0, "discounted_cash": 169.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88263 CHROMO MOSAIC 45 CELL 2K W BANDING", "code_information": [{"code": "88263", "type": "CPT"}, {"code": "198710", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 796.0, "discounted_cash": 159.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88264 CHROMOSOME ANAL, 20-25 CELLS", "code_information": [{"code": "88264", "type": "CPT"}, {"code": "164222", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 2640.0, "discounted_cash": 528.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88271 CYTOGENETICS DNA PROBE", "code_information": [{"code": "88271", "type": "CPT"}, {"code": "191480", "type": "CDM"}, {"code": "311", "type": "RC"}], "standard_charges": [{"gross_charge": 1036.0, "discounted_cash": 207.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88271 CYTOGENETICS DNA PROBE EA 1", "code_information": [{"code": "88271", "type": "CPT"}, {"code": "198712", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 1036.0, "discounted_cash": 207.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88275 CYTOGENETICS FISH 100 TO 300.2", "code_information": [{"code": "88275", "type": "CPT"}, {"code": "198724", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 59.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88275 CYTOGENETICS FISH 100 TO 300.3", "code_information": [{"code": "88275", "type": "CPT"}, {"code": "198726", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 59.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88275 MOLECULAR CYTOGENICS-ANALYZE 100-300 CELLS", "code_information": [{"code": "88275", "type": "CPT"}, {"code": "191488", "type": "CDM"}, {"code": "311", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 59.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88280 CHROMOSOME KARYOTYPE STUDY", "code_information": [{"code": "88280", "type": "CPT"}, {"code": "105454", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 38.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88285 CHROMOSOME ADD'L COUNT", "code_information": [{"code": "88285", "type": "CPT"}, {"code": "191494", "type": "CDM"}, {"code": "311", "type": "RC"}], "standard_charges": [{"gross_charge": 119.0, "discounted_cash": 23.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88291 CYTO/MOLECULAR REPORT", "code_information": [{"code": "88291", "type": "CPT"}, {"code": "105456", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 40.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88300 LEVEL I; GROSS EXAM ONLY", "code_information": [{"code": "88300", "type": "CPT"}, {"code": "105458", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 13.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88302 LEVEL II; GROSS AND MICRO EXAM", "code_information": [{"code": "88302", "type": "CPT"}, {"code": "105460", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 138.0, "discounted_cash": 27.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88304 LEVEL III; GROSS AND MICRO EXA", "code_information": [{"code": "88304", "type": "CPT"}, {"code": "105462", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 164.0, "discounted_cash": 32.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88305 LEVEL IV; GROSS AND MICRO EXAM", "code_information": [{"code": "88305", "type": "CPT"}, {"code": "105464", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 43.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88305 LEVEL IV; GROSS AND MICRO EXAM", "code_information": [{"code": "88305", "type": "CPT"}, {"code": "164228", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 43.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88305 PATH. SURG, LEVEL IV", "code_information": [{"code": "88305", "type": "CPT"}, {"code": "164226", "type": "CDM"}, {"code": "312", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 43.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88305 SURGICAL PATH G AND M LVL 4", "code_information": [{"code": "88305", "type": "CPT"}, {"code": "198732", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 218.0, "discounted_cash": 43.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88307 LEVEL V; GROSS AND MICRO EXAM", "code_information": [{"code": "88307", "type": "CPT"}, {"code": "105466", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 312.0, "discounted_cash": 62.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88309 LEVEL VI; GROSS AND MICRO EXAM", "code_information": [{"code": "88309", "type": "CPT"}, {"code": "105468", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 221.0, "discounted_cash": 44.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88311 DECALCIFY TISSUE", "code_information": [{"code": "88311", "type": "CPT"}, {"code": "105470", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 9.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88312 SPECIAL STAINS", "code_information": [{"code": "88312", "type": "CPT"}, {"code": "105472", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 46.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88313 SPECIAL STAIN - ALL OTHER", "code_information": [{"code": "88313", "type": "CPT"}, {"code": "164234", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 39.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88313 SPECIAL STAINS", "code_information": [{"code": "88313", "type": "CPT"}, {"code": "105474", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 706.0, "discounted_cash": 141.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88319 ENZYME HISTOCHEMISTRY", "code_information": [{"code": "88319", "type": "CPT"}, {"code": "105480", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 355.0, "discounted_cash": 71.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88323 MICROSLIDE CONSULTATION", "code_information": [{"code": "88323", "type": "CPT"}, {"code": "105484", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 36.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88329 PATH CONSULT INTROP", "code_information": [{"code": "88329", "type": "CPT"}, {"code": "105488", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 122.0, "discounted_cash": 24.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88331 PATH CONSULT INTRAOP, 1 BLOC", "code_information": [{"code": "88331", "type": "CPT"}, {"code": "105490", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 139.0, "discounted_cash": 27.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88332 PATH CONSULT INTRAOP, ADD/'L", "code_information": [{"code": "88332", "type": "CPT"}, {"code": "105492", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 13.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88333 INTRAOP CYTO PATH CONSULT, 1", "code_information": [{"code": "88333", "type": "CPT"}, {"code": "105494", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 105.0, "discounted_cash": 21.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88334 INTRAOP CYTO PATH CONSULT, 2", "code_information": [{"code": "88334", "type": "CPT"}, {"code": "105496", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 68.0, "discounted_cash": 13.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88341 IHC,EA ADDL AB PER SPECIMEN", "code_information": [{"code": "88341", "type": "CPT"}, {"code": "180018", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 257.0, "discounted_cash": 51.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88342 IHC STAIN, 1ST AB PER SPEC", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "175837", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 37.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88342 IMMUNOCHEM PER SPEC 1ST AB ID", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "198754", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 187.0, "discounted_cash": 37.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88342 IMMUNOHISTOCHEMISTRY", "code_information": [{"code": "88342", "type": "CPT"}, {"code": "105498", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 573.0, "discounted_cash": 114.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88344 IHC STAIN, EA ADD'L AB PER SLIDE", "code_information": [{"code": "88344", "type": "CPT"}, {"code": "175841", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 231.0, "discounted_cash": 46.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88346 IMMUNOFLUORESCENT PER SPEC; INI SNGL ANTIBDY STAIN PROC", "code_information": [{"code": "88346", "type": "CPT"}, {"code": "105500", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88348 ELECTRON MICROSCOPY", "code_information": [{"code": "88348", "type": "CPT"}, {"code": "105504", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 2061.0, "discounted_cash": 412.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88350 IMMUNOFL SNGL AB STAIN EA AD 2", "code_information": [{"code": "88350", "type": "CPT"}, {"code": "198770", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 169.0, "discounted_cash": 33.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88350 IMMUNOFLUOR ANTB ADDL STAIN", "code_information": [{"code": "88350", "type": "CPT"}, {"code": "183248", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 169.0, "discounted_cash": 33.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88360 ERA IMMUNOHISTO EA AB", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "198777", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 212.0, "discounted_cash": 42.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88360 MORPH ANALY TUMOR IMUUNOHISTO", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "198773", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 212.0, "discounted_cash": 42.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88360 TUMOR IMMUNOHISTOCHEM/MANUAL", "code_information": [{"code": "88360", "type": "CPT"}, {"code": "105514", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 212.0, "discounted_cash": 42.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88362 NERVE TEASING PREPARATIONS", "code_information": [{"code": "88362", "type": "CPT"}, {"code": "105518", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 491.0, "discounted_cash": 98.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88364 INSITU HYBRIDIZATION, EA ADDL PROBE", "code_information": [{"code": "88364", "type": "CPT"}, {"code": "180020", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 348.0, "discounted_cash": 69.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88365 INSITU HYBRIDIZATION (FISH)", "code_information": [{"code": "88365", "type": "CPT"}, {"code": "105520", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 413.0, "discounted_cash": 82.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88368 INSITU HYBRIDIZATION, MANUAL", "code_information": [{"code": "88368", "type": "CPT"}, {"code": "105524", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 464.0, "discounted_cash": 92.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88371 PROTEIN, WESTERN BLOT TISSUE", "code_information": [{"code": "88371", "type": "CPT"}, {"code": "105526", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 124.0, "discounted_cash": 24.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88372 PROTEIN ANALYSIS W/PROBE", "code_information": [{"code": "88372", "type": "CPT"}, {"code": "105528", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 153.0, "discounted_cash": 30.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88377 M/PHMTRC ALYS ISH,EA MULTIPLX PRB ST PROC", "code_information": [{"code": "88377", "type": "CPT"}, {"code": "180229", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 452.0, "discounted_cash": 90.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88381 MICRODISSECTION, MANUAL", "code_information": [{"code": "88381", "type": "CPT"}, {"code": "105532", "type": "CDM"}, {"code": "310", "type": "RC"}], "standard_charges": [{"gross_charge": 519.0, "discounted_cash": 103.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 88720 BILIRUBIN TOTAL TRANSCUT", "code_information": [{"code": "88720", "type": "CPT"}, {"code": "105540", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 53.0, "discounted_cash": 10.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 89050 BODY FLUID CELL COUNT", "code_information": [{"code": "89050", "type": "CPT"}, {"code": "105542", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 198.0, "discounted_cash": 39.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 89051 BODY FLUID CELL COUNT", "code_information": [{"code": "89051", "type": "CPT"}, {"code": "105544", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 283.0, "discounted_cash": 56.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 89055 LEUKOCYTE ASSESSMENT, FECAL", "code_information": [{"code": "89055", "type": "CPT"}, {"code": "105546", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 146.0, "discounted_cash": 29.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 89060 EXAM,SYNOVIAL FLUID CRYSTALS", "code_information": [{"code": "89060", "type": "CPT"}, {"code": "105548", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 479.0, "discounted_cash": 95.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 89190 NASAL SMEAR FOR EOSINOPHILS", "code_information": [{"code": "89190", "type": "CPT"}, {"code": "105554", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 319.0, "discounted_cash": 63.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 89220 SPUTUM SPECIMEN COLLECTION", "code_information": [{"code": "89220", "type": "CPT"}, {"code": "105556", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 48.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 89310 SEMEN ANALYSIS W/COUNT", "code_information": [{"code": "89310", "type": "CPT"}, {"code": "105562", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 196.0, "discounted_cash": 39.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 89320 SEMEN ANAL VOL/COUNT/MOT", "code_information": [{"code": "89320", "type": "CPT"}, {"code": "105564", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 296.0, "discounted_cash": 59.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 89321 SEMEN ANALY SPERM PRESENCE&/MOTILITY", "code_information": [{"code": "89321", "type": "CPT"}, {"code": "176537", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 63.0, "discounted_cash": 12.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90460 IMMUN ADMIN/COUNSEL,1ST VACCINE", "code_information": [{"code": "90460", "type": "CPT"}, {"code": "105628", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 8.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90461 IMMUN ADMIN/COUNSEL,EA ADD VACCINE", "code_information": [{"code": "90461", "type": "CPT"}, {"code": "105630", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 44.0, "discounted_cash": 8.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90471 IMMUN ADMIN VACCINE 1 VACCINE", "code_information": [{"code": "90471", "type": "CPT"}, {"code": "105632", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 256.0, "discounted_cash": 51.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90480 ADMN SARSCOV2 VACC 1 DOSE", "code_information": [{"code": "90480", "type": "CPT"}, {"code": "263147", "type": "CDM"}, {"code": "771", "type": "RC"}], "standard_charges": [{"gross_charge": 45.0, "discounted_cash": 9.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90620 MENB-4C RCMB/PROT/OUTMEMB VES VAC,2 DOSE IM", "code_information": [{"code": "90620", "type": "CPT"}, {"code": "188306", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 67.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90632 HEPATITIS A VACCINE ADULT FOR INTRAMUSCULAR USE", "code_information": [{"code": "90632", "type": "CPT"}, {"code": "105644", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 181.0, "discounted_cash": 36.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90633 HEPATITIS A VACCINE PEDIATRIC 2 DOSE SCHEDULE IM", "code_information": [{"code": "90633", "type": "CPT"}, {"code": "105646", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 103.0, "discounted_cash": 20.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90636 HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM", "code_information": [{"code": "90636", "type": "CPT"}, {"code": "105650", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 152.0, "discounted_cash": 30.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90647 HEMOPHILUS INFLUENZA B VACCINE PRP-OMP 3 DOSE IM", "code_information": [{"code": "90647", "type": "CPT"}, {"code": "105656", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 66.0, "discounted_cash": 13.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90648 HEMOPHILUS INFLUENZA B VACCINE PRP-T 4 DOSE IM", "code_information": [{"code": "90648", "type": "CPT"}, {"code": "105658", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 117.0, "discounted_cash": 23.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90649 HUMAN PAPILLOMA VIRUS VACCINE QUADRIV 3 DOSE IM", "code_information": [{"code": "90649", "type": "CPT"}, {"code": "105660", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 240.0, "discounted_cash": 48.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90656 INFLUENZA VIRUS VAC TRIVALENT,SV,PF 0.5ML IM", "code_information": [{"code": "90656", "type": "CPT"}, {"code": "105666", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 6.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90661 INFLUENZA VAC TRIVALENT CELL CULT PF,AF 0.5ML IM", "code_information": [{"code": "90661", "type": "CPT"}, {"code": "302067", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 6.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90662 FLU VAC PRSV FREE INC ANTIG", "code_information": [{"code": "90662", "type": "CPT"}, {"code": "177401", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 10.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90670 PNEUMOCOCCAL CONJ VACCINE 13 VALENT IM", "code_information": [{"code": "90670", "type": "CPT"}, {"code": "105676", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 984.0, "discounted_cash": 196.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90671 PNEUMOCOCCAL CONJUGATE VACC, 15 VALENT, IM USE", "code_information": [{"code": "90671", "type": "CPT"}, {"code": "365464", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 928.0, "discounted_cash": 185.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90675 RABIES VACCINE INTRAMUSCULAR", "code_information": [{"code": "90675", "type": "CPT"}, {"code": "105678", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 487.0, "discounted_cash": 97.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90677 PCV20 VACCINE IM", "code_information": [{"code": "90677", "type": "CPT"}, {"code": "188211", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 57.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90680 ROTAVIRUS VACCINE PENTAVALENT 3 DOSE LIVE ORAL", "code_information": [{"code": "90680", "type": "CPT"}, {"code": "105680", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 128.0, "discounted_cash": 25.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90681 ROTAVIRUS VACC HUMAN ATTENUATED 2 DOSE LIVE ORAL", "code_information": [{"code": "90681", "type": "CPT"}, {"code": "105682", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 154.0, "discounted_cash": 30.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90685 FLU VAC,QUADVAL,SV,PF 0.25ML IM (FLUZONE)", "code_information": [{"code": "90685", "type": "CPT"}, {"code": "177446", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 6.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90686 INFLUENZA VIRUS VAC,QUADVAL,SV,PF 0.5ML IM", "code_information": [{"code": "90686", "type": "CPT"}, {"code": "177444", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 33.0, "discounted_cash": 6.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90688 IIV4 VACC SPLIT VIRUS 0.5 ML IM", "code_information": [{"code": "90688", "type": "CPT"}, {"code": "247308", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 10.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90691 TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM", "code_information": [{"code": "90691", "type": "CPT"}, {"code": "105684", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 159.0, "discounted_cash": 31.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90696 DTAP-IPV INACTIVATED IF ADMIN PTS AGE 4-6 YRS IM", "code_information": [{"code": "90696", "type": "CPT"}, {"code": "105686", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 81.0, "discounted_cash": 16.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90700 DTAP VACCINE < 7 YR IM", "code_information": [{"code": "90700", "type": "CPT"}, {"code": "105690", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 113.0, "discounted_cash": 22.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90707 MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ", "code_information": [{"code": "90707", "type": "CPT"}, {"code": "105700", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 180.0, "discounted_cash": 36.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90710 MEASLES MUMPS RUBELLA VARICELLA VACC LIVE SUBQ", "code_information": [{"code": "90710", "type": "CPT"}, {"code": "105702", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 245.0, "discounted_cash": 49.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90713 POLIOVIRUS VACCINE INACTIVATED SUBQ/IM", "code_information": [{"code": "90713", "type": "CPT"}, {"code": "105706", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 90.0, "discounted_cash": 18.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90714 TD TOXOIDS ADSORBED PRSRV FR 7 YR IM", "code_information": [{"code": "90714", "type": "CPT"}, {"code": "105708", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 70.0, "discounted_cash": 14.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90715 TDAP VACCINE 7 YR IM", "code_information": [{"code": "90715", "type": "CPT"}, {"code": "105710", "type": "CDM"}, {"code": "250", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 25.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90716 VARICELLA VIRUS VACCINE LIVE SUBQ", "code_information": [{"code": "90716", "type": "CPT"}, {"code": "105712", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 329.0, "discounted_cash": 65.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90723 DTAP-HEPB-IPV VACCINE INTRAMUSCULAR", "code_information": [{"code": "90723", "type": "CPT"}, {"code": "105722", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 28.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90732 PNEUMOCOCCAL POLYSAC VACCINE 23-V 2 YR SUBQ/IM", "code_information": [{"code": "90732", "type": "CPT"}, {"code": "105724", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 577.0, "discounted_cash": 115.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90734 MENINGOCOCCAL CNJ VAC ACY&W135 QDVLNT IM", "code_information": [{"code": "90734", "type": "CPT"}, {"code": "105728", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 182.0, "discounted_cash": 36.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90736 ZOSTER SHINGLES VACCINE LIVE SUBCUTANEOUS", "code_information": [{"code": "90736", "type": "CPT"}, {"code": "105730", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 248.0, "discounted_cash": 49.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90740 HEP B VACCINE,DIAL/IMMUNOSUP, IM", "code_information": [{"code": "90740", "type": "CPT"}, {"code": "180897", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 567.0, "discounted_cash": 113.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90744 HEPATITIS B VACCINE PEDIATRIC3 DOSE IM", "code_information": [{"code": "90744", "type": "CPT"}, {"code": "105732", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 170.0, "discounted_cash": 34.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90746 HEPATITIS B VACCINE ADULT DOSAGE INTRAMUSCULAR", "code_information": [{"code": "90746", "type": "CPT"}, {"code": "105734", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 215.0, "discounted_cash": 43.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90750 ZOSTER SHINGLES VAC (HZV) RECOMB", "code_information": [{"code": "90750", "type": "CPT"}, {"code": "192296", "type": "CDM"}, {"code": "636", "type": "RC"}], "standard_charges": [{"gross_charge": 286.0, "discounted_cash": 57.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90785 PSYTX COMPLEX INTERACTIVE", "code_information": [{"code": "90785", "type": "CPT"}, {"code": "229640", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 507.0, "discounted_cash": 101.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90791 PSYCH DIAGNOSTIC EVAL, NO MEDICAL SERVICES", "code_information": [{"code": "90791", "type": "CPT"}, {"code": "187574", "type": "CDM"}, {"code": "900", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90792 PSYCH DIAGNOSTIC EVAL, W/MEDICAL SERVICES", "code_information": [{"code": "90792", "type": "CPT"}, {"code": "227437", "type": "CDM"}, {"code": "900", "type": "RC"}], "standard_charges": [{"gross_charge": 183.0, "discounted_cash": 36.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90832 PSYTX W PT 30 MINUTES", "code_information": [{"code": "90832", "type": "CPT"}, {"code": "217251", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 161.0, "discounted_cash": 32.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90833 PSYTX W PT W E/M 30 MIN", "code_information": [{"code": "90833", "type": "CPT"}, {"code": "227752", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 56.0, "discounted_cash": 11.2, "setting": "outpatient", "billing_class": "facility"}]}, 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"CPT"}, {"code": "229642", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90839 PSYTX CRISIS INITIAL 60 MIN", "code_information": [{"code": "90839", "type": "CPT"}, {"code": "229274", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 185.0, "discounted_cash": 37.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90846 FAM THER W/O PT 45-60 MIN -MA (CSV)", "code_information": [{"code": "90846", "type": "CPT"}, {"code": "187584", "type": "CDM"}, {"code": "916", "type": "RC"}], "standard_charges": [{"gross_charge": 189.0, "discounted_cash": 37.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 90847 FAM THER W/PT 45-60 MIN -MA", "code_information": [{"code": "90847", "type": "CPT"}, {"code": "187586", "type": "CDM"}, {"code": "916", "type": "RC"}], 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"billing_class": "facility"}]}, {"description": "HC 92507 TX SP LANG COMUNICAJ PCX DISORDER INDIV(ST)", "code_information": [{"code": "92507", "type": "CPT"}, {"code": "229820", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 521.0, "discounted_cash": 104.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "HC 92511 NASOPHARYNGOSCOPY W/ENDOSCOPE SPX", "code_information": [{"code": "92511", "type": "CPT"}, {"code": "105814", "type": "CDM"}, {"code": "450", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 33.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 92520 LARYNGEAL FUNCTION STUDIES(ST)", "code_information": [{"code": "92520", "type": "CPT"}, {"code": "212144", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 405.0, "discounted_cash": 81.0, "setting": "outpatient", "billing_class": "facility"}], 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"CPT"}, {"code": "106060", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 744.0, "discounted_cash": 148.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93922 TCPO2 LASER DOPPLER SGL LEVEL, UNILATERAL", "code_information": [{"code": "93922", "type": "CPT"}, {"code": "202865", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 752.0, "discounted_cash": 150.4, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "52"}, {"description": "HC 93922 TCPO2, SINGLE LEVEL", "code_information": [{"code": "93922", "type": "CPT"}, {"code": "164308", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 140.0, "discounted_cash": 28.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93923 N-INVAS PHYS STDY COMPL BILAT UPR/LXTR EXTRM ART 3+ LVLS", "code_information": [{"code": "93923", "type": "CPT"}, {"code": "106062", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2175.0, "discounted_cash": 435.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93923 TCPO2, MULTIPLE LEVELS", "code_information": [{"code": "93923", "type": "CPT"}, {"code": "202835", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 175.0, "discounted_cash": 35.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93923 TCPO2,MULTI LEVELS,UNILATERAL", "code_information": [{"code": "93923", "type": "CPT"}, {"code": "202833", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 66.4, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "52"}, {"description": "HC 93923 TRANSCUTANEOUS OXYGEN TENSION", "code_information": [{"code": "93923", "type": "CPT"}, {"code": "202831", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 332.0, "discounted_cash": 66.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93924 N-INVAS PHYSIOLOGIC STD LXTR ART REST FLWG STRS", "code_information": [{"code": "93924", "type": "CPT"}, {"code": "106064", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3642.0, "discounted_cash": 728.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93925 DUPLEX LWR ART/ABGRFT,CMPL BIL", "code_information": [{"code": "93925", "type": "CPT"}, {"code": "106066", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3287.0, "discounted_cash": 657.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93926 DUPLEX LWR ART/ABGRFT,UNI/LTD", "code_information": [{"code": "93926", "type": "CPT"}, {"code": "106068", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1959.0, "discounted_cash": 391.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93930 DUPLEX UPP ART/ABGRFT,CMPL/BIL", "code_information": [{"code": "93930", "type": "CPT"}, {"code": "106070", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1730.0, "discounted_cash": 346.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93931 DUPLEX UPP ART/ABGRFT,UNI/LTD", "code_information": [{"code": "93931", "type": "CPT"}, {"code": "106072", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1933.0, "discounted_cash": 386.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93970 DUPLEX EXTR VEINS; CMPL BILAT", "code_information": [{"code": "93970", "type": "CPT"}, {"code": "106074", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 3039.0, "discounted_cash": 607.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93971 DUPLEX EXTR VEINS; UNI/LTD", "code_information": [{"code": "93971", "type": "CPT"}, {"code": "106076", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2390.0, "discounted_cash": 478.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93975 DUPLEX ABD/PEL VASCULATUR COMPLETE", "code_information": [{"code": "93975", "type": "CPT"}, {"code": "106078", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 2016.0, "discounted_cash": 403.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93976 DUPLEX ABD/PEL VASCULATURE LTD", "code_information": [{"code": "93976", "type": "CPT"}, {"code": "106080", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1579.0, "discounted_cash": 315.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93978 DUPLEX AORTA/IVC COMPLETE", "code_information": [{"code": "93978", "type": "CPT"}, {"code": "106082", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1936.0, "discounted_cash": 387.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93979 DUPLEX AORTA/IVC F/U, LTD", "code_information": [{"code": "93979", "type": "CPT"}, {"code": "106084", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1347.0, "discounted_cash": 269.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93979 EVALUATE TIPS", "code_information": [{"code": "93979", "type": "CPT"}, {"code": "164310", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1347.0, "discounted_cash": 269.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93980 DUPLEX PENILE VASC COMP", "code_information": [{"code": "93980", "type": "CPT"}, {"code": "106086", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1936.0, "discounted_cash": 387.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93981 DUPLEX PENILE VASC F/U, LTD", "code_information": [{"code": "93981", "type": "CPT"}, {"code": "106088", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 1347.0, "discounted_cash": 269.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93985 DUPLEX SCAN ARTL INFL&VEN HEMO COMPL BILAT", "code_information": [{"code": "93985", "type": "CPT"}, {"code": "214857", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": [{"gross_charge": 968.0, "discounted_cash": 193.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 93986 DUPLEX SCAN ARTL INFL&VEN HEMO COMPL UNILAT", "code_information": [{"code": "93986", "type": "CPT"}, {"code": "214859", "type": "CDM"}, {"code": "921", "type": "RC"}], "standard_charges": 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"discounted_cash": 792.0, "setting": "inpatient", "billing_class": "facility"}]}, {"description": "HC 94010 BREATHING CAPACITY TEST", "code_information": [{"code": "94010", "type": "CPT"}, {"code": "164316", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 127.0, "discounted_cash": 25.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94010 PUL FCT WO BR", "code_information": [{"code": "94010", "type": "CPT"}, {"code": "164312", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 877.0, "discounted_cash": 175.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94060 BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN", "code_information": [{"code": "94060", "type": "CPT"}, {"code": "106102", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 285.0, "discounted_cash": 57.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94070 BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT", "code_information": [{"code": "94070", "type": "CPT"}, {"code": "106104", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 2439.0, "discounted_cash": 487.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94150 PEAK FLOW METER", "code_information": [{"code": "94150", "type": "CPT"}, {"code": "106106", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 605.0, "discounted_cash": 121.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94200 MAXIMAL VOLUNTARY VENTILATION (MBC/MVV)", "code_information": [{"code": "94200", "type": "CPT"}, {"code": "164320", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 57.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94610 INTRAPULMONARY SURFACTANT ADMINISTRATION", "code_information": [{"code": "94610", "type": "CPT"}, {"code": "106124", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1145.0, "discounted_cash": 229.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94618 PULM STRS TST (EG 6-MIN WLK TST)", "code_information": [{"code": "94618", "type": "CPT"}, {"code": "182871", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 121.0, "discounted_cash": 24.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94621 CARDPULM EXER TST (CO2, O2,EKG)", "code_information": [{"code": "94621", "type": "CPT"}, {"code": "177509", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 3239.0, "discounted_cash": 647.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94625 PHY/QHP OP PULM RHB WO/MNTR", "code_information": [{"code": "94625", "type": "CPT"}, {"code": "182220", "type": "CDM"}, {"code": "948", "type": "RC"}], "standard_charges": [{"gross_charge": 483.0, "discounted_cash": 96.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94640 MDI/NEB INITIAL", "code_information": [{"code": "94640", "type": "CPT"}, {"code": "176096", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 1010.0, "discounted_cash": 202.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94640 PRESS/N-PRESS INHLJ TX F/AAO/SPTM INDCTJ", "code_information": [{"code": "94640", "type": "CPT"}, {"code": "106130", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 237.0, "discounted_cash": 47.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94642 AERSL INHLJ PENTAMIDINE F/PCP TX/PROPH", "code_information": [{"code": "94642", "type": "CPT"}, {"code": "106132", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 788.0, "discounted_cash": 157.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94644 CONTINUOUS INHALATION TREATMENT 1ST HR", "code_information": [{"code": "94644", "type": "CPT"}, {"code": "106134", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 489.0, "discounted_cash": 97.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94645 CONTINUOUS INHALATION TREATMENT EA ADDL HR", "code_information": [{"code": "94645", "type": "CPT"}, {"code": "106136", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 380.0, "discounted_cash": 76.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94660 CPAP/BIPAP INITIATION/MGMT", "code_information": [{"code": "94660", "type": "CPT"}, {"code": "106142", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 5591.0, "discounted_cash": 1118.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94660 CPAP/BIPAP SUBSEQUENT/MGMT", "code_information": [{"code": "94660", "type": "CPT"}, {"code": "259964", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 3960.0, "discounted_cash": 792.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94664 DEMO &/EVAL PT USE OF INHALER", "code_information": [{"code": "94664", "type": "CPT"}, {"code": "106144", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 235.0, "discounted_cash": 47.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94667 MNPJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL", "code_information": [{"code": "94667", "type": "CPT"}, {"code": "106146", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 642.0, "discounted_cash": 128.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94668 CHEST PHYSIOTHERAPY, SUBSEQUEN", "code_information": [{"code": "94668", "type": "CPT"}, {"code": "166090", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 80.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94668 MNPJ CH FACILITATE LNG FUNCJ SBSQ", "code_information": [{"code": "94668", "type": "CPT"}, {"code": "106148", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 80.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94669 MECH CHEST WALL OSCILLATION", "code_information": [{"code": "94669", "type": "CPT"}, {"code": "238817", "type": "CDM"}, {"code": "410", "type": "RC"}], "standard_charges": [{"gross_charge": 858.0, "discounted_cash": 171.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94681 O2/CO2 EXHALED AIR ANALYSIS", "code_information": [{"code": "94681", "type": "CPT"}, {"code": "194930", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 38.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94726 PLETHYSMOGRAPHY", "code_information": [{"code": "94726", "type": "CPT"}, {"code": "106114", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 1447.0, "discounted_cash": 289.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94729 DIFFUSION STUDIES", "code_information": [{"code": "94729", "type": "CPT"}, {"code": "106152", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 92.0, "discounted_cash": 18.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94760 PULSE OXIMETER SINGLE DET, SUB", "code_information": [{"code": "94760", "type": "CPT"}, {"code": "164356", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 58.0, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "76"}, {"description": "HC 94760 PULSE OXIMETER, SINGLE DET", "code_information": [{"code": "94760", "type": "CPT"}, {"code": "106158", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 28.0, "discounted_cash": 5.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94760 PULSE OXIMETER, SINGLE DET", "code_information": [{"code": "94760", "type": "CPT"}, {"code": "164354", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 290.0, "discounted_cash": 58.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94761 PULSE OXIMETER, MULTIPLE DET", "code_information": [{"code": "94761", "type": "CPT"}, {"code": "106160", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": 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"outpatient", "billing_class": "facility"}]}, {"description": "HC 94799 INCENTIVE SPIROMETRY,SUBSEQUEN", "code_information": [{"code": "94799", "type": "CPT"}, {"code": "202809", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 289.0, "discounted_cash": 57.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 94799 UNLISTED PULMONARY SVC/PX", "code_information": [{"code": "94799", "type": "CPT"}, {"code": "106172", "type": "CDM"}, {"code": "460", "type": "RC"}], "standard_charges": [{"gross_charge": 418.0, "discounted_cash": 83.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95115 PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX", "code_information": [{"code": "95115", "type": "CPT"}, {"code": "106180", "type": "CDM"}, {"code": "940", "type": "RC"}], "standard_charges": [{"gross_charge": 57.0, "discounted_cash": 11.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": 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{"code": "214887", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 12580.0, "discounted_cash": 2516.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95782 POLYSOMNOGRAPHY W/4+ SLEEP PAR PEDI < 6 YRS", "code_information": [{"code": "95782", "type": "CPT"}, {"code": "298510", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 10971.0, "discounted_cash": 2194.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95783 POLYSOM <6 YRS CPAP/BILVL", "code_information": [{"code": "95783", "type": "CPT"}, {"code": "301991", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 12170.0, "discounted_cash": 2434.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95800 SLP STDY UNATND W/HRTRT/O2/RSP", "code_information": [{"code": "95800", "type": "CPT"}, {"code": "260174", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 158.0, "discounted_cash": 31.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95805 MULTIPLE SLEEP LATENCY TEST", "code_information": [{"code": "95805", "type": "CPT"}, {"code": "106190", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 5863.0, "discounted_cash": 1172.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95810 POLYSOMNOGRAPHY W/4+ SLEEP PAR", "code_information": [{"code": "95810", "type": "CPT"}, {"code": "106194", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 10971.0, "discounted_cash": 2194.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95810 POLYSOMNOGRAPHY W/4+ SLEEP PAR<6HRS REC", "code_information": [{"code": "95810", "type": "CPT"}, {"code": "202869", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 10971.0, "discounted_cash": 2194.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "52"}, {"description": "HC 95811 POLYSOMNOGRAPHY WITH CPAP", "code_information": [{"code": "95811", "type": "CPT"}, {"code": "106196", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 12170.0, "discounted_cash": 2434.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95811 POLYSOMNOGRAPHY WITH CPAP <6HR REC", "code_information": [{"code": "95811", "type": "CPT"}, {"code": "202871", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 12170.0, "discounted_cash": 2434.0, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "52"}, {"description": "HC 95812 ROUTINE EEG 41-60 MINUTES", "code_information": [{"code": "95812", "type": "CPT"}, {"code": "106198", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 1484.0, "discounted_cash": 296.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95813 EEG EXTND MNTR 61-119 MINUTES", "code_information": [{"code": "95813", "type": "CPT"}, {"code": "106200", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 1623.0, "discounted_cash": 324.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95816 ROUTINE EEG AWAKE/DROWSY", "code_information": [{"code": "95816", "type": "CPT"}, {"code": "106202", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 1793.0, "discounted_cash": 358.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95819 ROUTINE EEG AWAKE/ASLEEP", "code_information": [{"code": "95819", "type": "CPT"}, {"code": "106204", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 1793.0, "discounted_cash": 358.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95822 ROUTINE EEG COMA/SLEEP ONLY", "code_information": [{"code": "95822", "type": "CPT"}, {"code": "106206", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 1950.0, "discounted_cash": 390.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95824 EEG CEREBRAL DEATH EVALUATION", "code_information": [{"code": "95824", "type": "CPT"}, {"code": "106208", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 1084.0, "discounted_cash": 216.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95860 NEEDLE EMG-ONE EXTREMITY", "code_information": [{"code": "95860", "type": "CPT"}, {"code": "106212", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 160.0, "discounted_cash": 32.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95861 NEEDLE EMG-TWO EXTREMITIES", "code_information": [{"code": "95861", "type": "CPT"}, {"code": "106214", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 195.0, "discounted_cash": 39.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95864 NEEDLE EMG-FOUR EXTREMITIES", "code_information": [{"code": "95864", "type": "CPT"}, {"code": "106218", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 204.0, "discounted_cash": 40.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95867 EMG-CRANIAL NERVE-UNILATERAL", "code_information": [{"code": "95867", "type": "CPT"}, {"code": "106220", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 301.0, "discounted_cash": 60.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95868 MUSCLE TEST CRAN NERV BILAT", "code_information": [{"code": "95868", "type": "CPT"}, {"code": "298518", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 390.0, "discounted_cash": 78.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95869 EMG-THORACIC PARASPINAL", "code_information": [{"code": "95869", "type": "CPT"}, {"code": "106224", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 190.0, "discounted_cash": 38.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95870 EMG OTHER THAN THORACIC PARASPINAL", "code_information": [{"code": "95870", "type": "CPT"}, {"code": "106226", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 166.0, "discounted_cash": 33.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95874 GUIDE NERV DESTR, NEEDLE EMG", "code_information": [{"code": "95874", "type": "CPT"}, {"code": "106228", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 82.0, "discounted_cash": 16.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95885 MUSC TST W/NERV TST;LIMITED", "code_information": [{"code": "95885", "type": "CPT"}, {"code": "210780", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 137.0, "discounted_cash": 27.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95886 MUSC TST W/NERV TST;COMPLETE", "code_information": [{"code": "95886", "type": "CPT"}, {"code": "210778", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 210.0, "discounted_cash": 42.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95887 MUSC TST W/NERV TST NON-EXTREMITY", "code_information": [{"code": "95887", "type": "CPT"}, {"code": "210776", "type": "CDM"}, {"code": "922", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 25.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95907 NRV COND STDY; 1-2 STUDIES", "code_information": [{"code": "95907", "type": "CPT"}, {"code": "273843", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 136.0, "discounted_cash": 27.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95908 NRV COND STDY; 3-4 STUDIES", "code_information": [{"code": "95908", "type": "CPT"}, {"code": "273845", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 285.0, "discounted_cash": 57.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95909 NRV COND STDY; 5-6 STUDIES", "code_information": [{"code": "95909", "type": "CPT"}, {"code": "273847", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 278.0, "discounted_cash": 55.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95910 NRV COND STDY; 7-8 STUDIES", "code_information": [{"code": "95910", "type": "CPT"}, {"code": "273849", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 372.0, "discounted_cash": 74.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95911 NRV COND STDY; 9-10 STUDIES", "code_information": [{"code": "95911", "type": "CPT"}, {"code": "273851", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 525.0, "discounted_cash": 105.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95912 NRV COND STDY; 11-12 STUDIES", "code_information": [{"code": "95912", "type": "CPT"}, {"code": "273853", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 445.0, "discounted_cash": 89.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95913 NRV COND STDY; >=13 STUDIES", "code_information": [{"code": "95913", "type": "CPT"}, {"code": "273855", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": 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"setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95937 NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH", "code_information": [{"code": "95937", "type": "CPT"}, {"code": "106250", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 25.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95938 SSEP - UPPER & LOWER LIMBS", "code_information": [{"code": "95938", "type": "CPT"}, {"code": "202845", "type": "CDM"}, {"code": "740", "type": "RC"}], "standard_charges": [{"gross_charge": 2659.0, "discounted_cash": 531.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95970 ELEC ALYS NSTIM PLS GEN BRN/SC/PERPH W/O REPRGRM", "code_information": [{"code": "95970", "type": "CPT"}, {"code": "106268", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 126.0, "discounted_cash": 25.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95971 ELEC ALYS NSTIM PLS GEN SMPL SC/PERPH W/PRGRMG", "code_information": [{"code": "95971", "type": "CPT"}, {"code": "106270", "type": "CDM"}, {"code": "360", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 34.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95972 ELEC ALYS NSTIM PLS GEN CPLX SC/PRPH", "code_information": [{"code": "95972", "type": "CPT"}, {"code": "106272", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 171.0, "discounted_cash": 34.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95976 ELEC ALYS NSTIM PLS GEN SMPL CN NPGT PRGM", "code_information": [{"code": "95976", "type": "CPT"}, {"code": "200108", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 10.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95977 ELEC ALYS NSTIM PLS GEN CPLX CN NPGT PRGM", "code_information": [{"code": "95977", "type": "CPT"}, {"code": "200110", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 125.0, "discounted_cash": 25.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95983 ELEC ALYS NSTIM PLS GEN BRN NPGT PRGM 15 MIN", "code_information": [{"code": "95983", "type": "CPT"}, {"code": "200104", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 114.0, "discounted_cash": 22.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95984 ELEC ALYS NSTIM PLS GEN BRN NPGT PRGM EA ADD'L 15 MIN", "code_information": [{"code": "95984", "type": "CPT"}, {"code": "200106", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 50.0, "discounted_cash": 10.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 95992 CANALITH REPOSITIONING PROC(EPLEY) (PT)", "code_information": [{"code": "95992", "type": "CPT"}, {"code": "229848", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 554.0, "discounted_cash": 110.8, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 96110 DELPMNTL SCRN W SCORE/DOC INSTRUMNT", "code_information": [{"code": "96110", "type": "CPT"}, {"code": "179923", "type": "CDM"}, {"code": "920", "type": "RC"}], "standard_charges": [{"gross_charge": 255.0, "discounted_cash": 51.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96125 STAND COGNITIVE PERF TEST (ST)", "code_information": [{"code": "96125", "type": "CPT"}, {"code": "229852", "type": "CDM"}, {"code": "442", "type": "RC"}], "standard_charges": [{"gross_charge": 728.0, "discounted_cash": 145.6, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "HC 96127 BRIEF EMOTIONAL/BEHAV ASSMNT", "code_information": [{"code": "96127", "type": "CPT"}, {"code": "209394", "type": "CDM"}, {"code": "918", "type": "RC"}], "standard_charges": [{"gross_charge": 48.0, "discounted_cash": 9.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96130 PSYCHOLOGICAL TST EVAL SVC PHYS/QHP 1ST HR", "code_information": [{"code": "96130", "type": "CPT"}, {"code": "227439", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 443.0, "discounted_cash": 88.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96136 PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN", "code_information": [{"code": "96136", "type": "CPT"}, {"code": "227414", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 121.0, "discounted_cash": 24.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96160 PT-FCSD HLTH RISK ASSMT SCR DOC STND INSTRM", "code_information": [{"code": "96160", "type": "CPT"}, {"code": "228455", "type": "CDM"}, {"code": "510", "type": "RC"}], "standard_charges": [{"gross_charge": 43.0, "discounted_cash": 8.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96360 IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR", "code_information": [{"code": "96360", "type": "CPT"}, {"code": "106284", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 921.0, "discounted_cash": 184.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96361 IV INFUSION HYDRATION EACH ADDITIONAL HOUR", "code_information": [{"code": "96361", "type": "CPT"}, {"code": "106286", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 145.0, "discounted_cash": 29.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96365 IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST UP TO 1 HOUR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "106288", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 960.0, "discounted_cash": 192.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96365 IVIG ADMIN, IV UP TO 1HR INITIAL", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "302256", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 960.0, "discounted_cash": 192.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96366 IV INFUSION THERAPY PROPHYLAXIS/DX EA ADDL HOUR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "106290", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 139.0, "discounted_cash": 27.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96366 IVIG ADMIN, IV EA ADD'L HOUR", "code_information": [{"code": "96366", "type": "CPT"}, {"code": "302258", "type": "CDM"}, {"code": "260", "type": "RC"}], 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"facility"}]}, {"description": "HC 96376 IV PUSH,SAME DRUG,AFTER 30 MIN", "code_information": [{"code": "96376", "type": "CPT"}, {"code": "106304", "type": "CDM"}, {"code": "260", "type": "RC"}], "standard_charges": [{"gross_charge": 143.0, "discounted_cash": 28.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96401 CHEMO ADMIN,SUBQ/IM, NON-HORMON", "code_information": [{"code": "96401", "type": "CPT"}, {"code": "106308", "type": "CDM"}, {"code": "331", "type": "RC"}], "standard_charges": [{"gross_charge": 426.0, "discounted_cash": 85.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96402 CHEMO ADMIN,SUBQ/IM,;HORMON ANTINEOPLASTIC", "code_information": [{"code": "96402", "type": "CPT"}, {"code": "106310", "type": "CDM"}, {"code": "331", "type": "RC"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 66.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96409 CHEMO IV PUSH; SINGLE DRUG", "code_information": [{"code": "96409", "type": "CPT"}, {"code": "106312", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 1845.0, "discounted_cash": 369.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96411 CHEMO IV PUSH; EA ADD'L DRUG", "code_information": [{"code": "96411", "type": "CPT"}, {"code": "106314", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 1814.0, "discounted_cash": 362.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96413 CHEMO ADMIN, IV <1HR INITIAL", "code_information": [{"code": "96413", "type": "CPT"}, {"code": "106316", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 960.0, "discounted_cash": 192.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96415 CHEMO ADMIN, IV EA ADD'L HOUR", "code_information": [{"code": "96415", "type": "CPT"}, {"code": "106318", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 330.0, "discounted_cash": 66.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96416 CHEMO INITIATION, PROLONG INFUSE W/PUMP", "code_information": [{"code": "96416", "type": "CPT"}, {"code": "273586", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 2636.0, "discounted_cash": 527.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96417 CHEMO ADMIN, IV EA ADD'L SEQ <1", "code_information": [{"code": "96417", "type": "CPT"}, {"code": "106320", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 1186.0, "discounted_cash": 237.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96420 CHEMOTX ADMN IA PUSH TQ", "code_information": [{"code": "96420", "type": "CPT"}, {"code": "106322", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 1785.0, "discounted_cash": 357.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96450 CHEMOTHERAPY INTO CNS", "code_information": [{"code": "96450", "type": "CPT"}, {"code": "275427", "type": "CDM"}, {"code": "331", "type": "RC"}], "standard_charges": [{"gross_charge": 2974.0, "discounted_cash": 594.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96523 IRRIGAJ IMPLNTD VENOUS ACC DRUG DEL SYST", "code_information": [{"code": "96523", "type": "CPT"}, {"code": "176572", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 60.0, "discounted_cash": 12.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96549 CHEMO ADMIN, CONCURRENT", "code_information": [{"code": "96549", "type": "CPT"}, {"code": "177674", "type": "CDM"}, {"code": "335", "type": "RC"}], "standard_charges": [{"gross_charge": 890.0, "discounted_cash": 178.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96900 PHOTOTHERAPY", "code_information": [{"code": "96900", "type": "CPT"}, {"code": "212164", "type": "CDM"}, {"code": "940", "type": "RC"}], "standard_charges": [{"gross_charge": 203.0, "discounted_cash": 40.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 96999 BILITE PHOTOTHERAPY", "code_information": [{"code": "96999", "type": "CPT"}, {"code": "190036", "type": "CDM"}, {"code": "761", "type": "RC"}], "standard_charges": [{"gross_charge": 1009.0, "discounted_cash": 201.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC 97010 HOT OR COLD PACKS THERAPY (OT)", "code_information": [{"code": "97010", "type": "CPT"}, {"code": "229854", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 38.4, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97010 HOT OR COLD PACKS THERAPY(PT)", "code_information": [{"code": "97010", "type": "CPT"}, {"code": "229856", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 192.0, "discounted_cash": 38.4, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 97012 MECHANICAL TRACTION THERAPY(PT)", "code_information": [{"code": "97012", "type": "CPT"}, {"code": "229858", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 50.8, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 97014 ELEC STIMULATION THERAPY (UNATTENDED) (OT)", "code_information": [{"code": "97014", "type": "CPT"}, {"code": "229862", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 456.0, "discounted_cash": 91.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97014 ELEC STIMULATION THERAPY (UNATTENDED)(PT)", "code_information": [{"code": "97014", "type": "CPT"}, {"code": "229860", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 456.0, "discounted_cash": 91.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 97016 VASOPNEUMATIC DEVICE THERAPY(OT)", "code_information": [{"code": "97016", "type": "CPT"}, {"code": "229864", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 31.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97016 VASOPNEUMATIC DEVICE THERAPY(PT)", "code_information": [{"code": "97016", "type": "CPT"}, {"code": "212166", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 156.0, "discounted_cash": 31.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 97018 PARAFIN BATH THERAPY (OT)", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "229868", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 47.8, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97018 PARAFIN BATH THERAPY(PT)", "code_information": [{"code": "97018", "type": "CPT"}, {"code": "229866", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 47.8, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 97022 WHIRLPOOL THERAPY (OT)", "code_information": [{"code": "97022", "type": "CPT"}, {"code": "229872", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 418.0, "discounted_cash": 83.6, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97022 WHIRLPOOL THERAPY(PT)", "code_information": 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"97033", "type": "CPT"}, {"code": "229882", "type": "CDM"}, {"code": "432", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 41.8, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97033 IONTOPHORESIS EA 15 MIN(PT)", "code_information": [{"code": "97033", "type": "CPT"}, {"code": "229880", "type": "CDM"}, {"code": "422", "type": "RC"}], "standard_charges": [{"gross_charge": 209.0, "discounted_cash": 41.8, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 97035 ULTRASOUND EA. 15' MIN (OT)", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "229890", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 53.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97035 ULTRASOUND EA. 15' MIN(PT)", "code_information": [{"code": "97035", "type": "CPT"}, {"code": "229888", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 266.0, "discounted_cash": 53.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 97110 THER PROC STR FLEX.ROM 15(OT)", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "229966", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 67.4, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97110 THER PROC.STR.,FLEX,ROM EA.15'(PT)", "code_information": [{"code": "97110", "type": "CPT"}, {"code": "229972", "type": "CDM"}, {"code": "422", "type": "RC"}], "standard_charges": [{"gross_charge": 337.0, "discounted_cash": 67.4, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 97112 NEUROMUSCULAR REEDUCATION 15' (OT)", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "229964", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 48.8, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97112 NEUROMUSCULAR REEDUCATION 15'(PT)", "code_information": [{"code": "97112", "type": "CPT"}, {"code": "229962", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 244.0, "discounted_cash": 48.8, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 97113 AQUA THERAPY W/EXER EA 15 MIN(PT)", "code_information": [{"code": "97113", "type": "CPT"}, {"code": "229960", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 291.0, "discounted_cash": 58.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 97116 GAIT TRAINING EA 15 MIN(PT)", "code_information": [{"code": "97116", "type": "CPT"}, {"code": "229958", "type": "CDM"}, {"code": "420", "type": "RC"}], "standard_charges": [{"gross_charge": 254.0, "discounted_cash": 50.8, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GP"}, {"description": "HC 97124 MASSAGE 15M (OT)", "code_information": [{"code": "97124", "type": "CPT"}, {"code": "229894", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 141.0, "discounted_cash": 28.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97129 THER IVNTJ COG FUNCJ CNTCT 1ST 15 MIN(OT)", "code_information": [{"code": "97129", "type": "CPT"}, {"code": "229896", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 281.0, "discounted_cash": 56.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97129 THER IVNTJ COG FUNCJ CNTCT 1ST 15 MIN(ST)", "code_information": [{"code": "97129", "type": "CPT"}, {"code": "229898", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 281.0, "discounted_cash": 56.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "HC 97130 THER IVNTJ COG FUNCJ CNTCT ADDL 15 MIN(OT)", "code_information": [{"code": "97130", "type": "CPT"}, {"code": "229900", "type": "CDM"}, {"code": "430", "type": "RC"}], "standard_charges": [{"gross_charge": 281.0, "discounted_cash": 56.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GO"}, {"description": "HC 97130 THER IVNTJ COG FUNCJ CNTCT ADDL 15 MIN(ST)", "code_information": [{"code": "97130", "type": "CPT"}, {"code": "229902", "type": "CDM"}, {"code": "440", "type": "RC"}], "standard_charges": [{"gross_charge": 281.0, "discounted_cash": 56.2, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "GN"}, {"description": "HC 97140 MANUAL THERAPY EA 15 MIN (OT)", "code_information": [{"code": "97140", "type": "CPT"}, {"code": "229906", 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{"description": "HC PART TRAUMA ACT WO CRIT CARE", "code_information": [{"code": "164408", "type": "CDM"}, {"code": "682", "type": "RC"}], "standard_charges": [{"gross_charge": 96656.0, "discounted_cash": 19331.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 10004 FINE NDL ASP BX W/O IMG GDE; EA ADD'L LESION", "code_information": [{"code": "10004", "type": "CPT"}, {"code": "200128", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 230.0, "discounted_cash": 46.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 10005 FINE NDL ASP BX W/ US GDE; 1ST LESION", "code_information": [{"code": "10005", "type": "CPT"}, {"code": "200013", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 550.0, "discounted_cash": 110.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 10006 FINE NDL ASP BX W/ US GDE; EA ADD'L LESION", "code_information": [{"code": "10006", "type": "CPT"}, {"code": "200015", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 364.0, "discounted_cash": 72.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 10021 FINE NDL ASP BX W/O IMG GDE; 1ST LESION", "code_information": [{"code": "10021", "type": "CPT"}, {"code": "116861", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 85.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 10060 I&D ABSCESS,SIMPLE/SINGLE", "code_information": [{"code": "10060", "type": "CPT"}, {"code": "116867", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 515.0, "discounted_cash": 103.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 10061 I&D OF ABSCESS, COMP/MULT", "code_information": [{"code": "10061", "type": "CPT"}, {"code": 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"standard_charges": [{"gross_charge": 658.0, "discounted_cash": 131.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 10121 INCN & REMVL FB SUBQ TIS;COMPLICATED", "code_information": [{"code": "10121", "type": "CPT"}, {"code": "116877", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1184.0, "discounted_cash": 236.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 10140 I&D HEMATOMA/SEROMA OR FLUID COLLECT", "code_information": [{"code": "10140", "type": "CPT"}, {"code": "116879", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 145.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 10160 PUNCT/ASP ABSCESS, HEMAT, BULLA, OR CYST", "code_information": [{"code": "10160", "type": "CPT"}, {"code": "116881", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 564.0, "discounted_cash": 112.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 10180 I&D, COMPLEX, POSTOP WOUND INFECT", "code_information": [{"code": "10180", "type": "CPT"}, {"code": "116883", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1167.0, "discounted_cash": 233.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11000 DEBRIDE INF SKIN; UP TO 10%", "code_information": [{"code": "11000", "type": "CPT"}, {"code": "116885", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 299.0, "discounted_cash": 59.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11010 DEBRIDE SKIN, FX", "code_information": [{"code": "11010", "type": "CPT"}, {"code": "116889", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2098.0, "discounted_cash": 419.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11012 DEBRIDE SKIN/MUSCLE/BONE, FX", "code_information": [{"code": "11012", "type": "CPT"}, {"code": "116891", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 3007.0, "discounted_cash": 601.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11042 DEBRIDE SQ TIS 1ST <= 20 SQ CM", "code_information": [{"code": "11042", "type": "CPT"}, {"code": "116893", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 527.0, "discounted_cash": 105.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11043 DEBRIDE MUSL/FAS 1ST <= 20 SQ CM", "code_information": [{"code": "11043", "type": "CPT"}, {"code": "116895", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 1004.0, "discounted_cash": 200.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11044 DEBRIDE BONE 1ST <= 20 SQ CM", "code_information": [{"code": "11044", "type": "CPT"}, {"code": "116897", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1366.0, "discounted_cash": 273.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11102 TANGNTL BX SKIN; SNGL LESION", "code_information": [{"code": "11102", "type": "CPT"}, {"code": "200130", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 425.0, "discounted_cash": 85.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11200 REMOVAL SKIN TAGS, <=15 LES", "code_information": [{"code": "11200", "type": "CPT"}, {"code": "116915", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 384.0, "discounted_cash": 76.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11300 SHAV SKIN LES SNGL T/A/L; 0.5CM/<", "code_information": [{"code": "11300", "type": "CPT"}, {"code": "116919", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 420.0, "discounted_cash": 84.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11301 SHAV SKIN LES SNGL T/A/L; 0.6-1.0 CM", "code_information": [{"code": "11301", "type": "CPT"}, {"code": "116921", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 516.0, "discounted_cash": 103.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11310 SHAV SKIN LES SNGL F/E/E/N/L/M; 0.5 CM/<", "code_information": [{"code": "11310", "type": "CPT"}, {"code": "116935", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 490.0, "discounted_cash": 98.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11400 EXC LES B9MARG T/A/L; 0.5 < CM", "code_information": [{"code": "11400", "type": "CPT"}, {"code": "116943", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 107.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11401 EXC LES B9MARG T/A/L; 0.6-1 CM", "code_information": [{"code": "11401", "type": "CPT"}, {"code": "116945", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 654.0, "discounted_cash": 130.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11402 EXC LES B9MARG T/A/L; 1.1-2 CM", "code_information": [{"code": "11402", "type": "CPT"}, {"code": "116947", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 727.0, "discounted_cash": 145.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11406 EXC LES B9MARG T/A/L; > 4.0 CM", "code_information": [{"code": "11406", "type": "CPT"}, {"code": "116953", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": 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"discounted_cash": 12.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11730 AVULSION NAIL PLATE,PART/COMPL,SMPL; SNGL", "code_information": [{"code": "11730", "type": "CPT"}, {"code": "117013", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 473.0, "discounted_cash": 94.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11732 AVULSION NAIL PLATE,PART/COMPL,SMPL; EA ADD'L", "code_information": [{"code": "11732", "type": "CPT"}, {"code": "117015", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 216.0, "discounted_cash": 43.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11740 EVAC SUBUNGUAL HEMATOMA", "code_information": [{"code": "11740", "type": "CPT"}, {"code": "117017", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 222.0, "discounted_cash": 44.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11760 REPAIR OF NAIL BED", "code_information": [{"code": "11760", "type": "CPT"}, {"code": "117025", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 974.0, "discounted_cash": 194.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 11765 WEDGE EXC OF NAIL FOLD, TOE", "code_information": [{"code": "11765", "type": "CPT"}, {"code": "117027", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 731.0, "discounted_cash": 146.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12001 SMPL REP S/N/AX/G/TR; 2.5CM/<", "code_information": [{"code": "12001", "type": "CPT"}, {"code": "117037", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 386.0, "discounted_cash": 77.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12002 SMPL REP S/N/AX/G/TR; 2.6-7.5CM", "code_information": [{"code": "12002", "type": "CPT"}, {"code": "117039", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 471.0, "discounted_cash": 94.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12004 SMPL REP S/N/AX/G/TR; 7.6-12.5CM", "code_information": [{"code": "12004", "type": "CPT"}, {"code": "117041", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 553.0, "discounted_cash": 110.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12005 SMPL REP S/N/A/G/T/H/F; 12.6-20.0 CM", "code_information": [{"code": "12005", "type": "CPT"}, {"code": "117043", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 718.0, "discounted_cash": 143.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12006 SMPL REP S/N/A/G/T/H/F; 20.1-30.0 CM", "code_information": [{"code": "12006", "type": "CPT"}, {"code": "117045", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 848.0, "discounted_cash": 169.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12007 SMPL REP S/N/A/G/T/H/F; >30.0CM", "code_information": [{"code": "12007", "type": "CPT"}, {"code": "117047", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 975.0, "discounted_cash": 195.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12011 SMPL REP F/E/E/N/L/MM; <=2.5CM", "code_information": [{"code": "12011", "type": "CPT"}, {"code": "117049", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 472.0, "discounted_cash": 94.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12013 SMPL REP F/E/E/N/L/M; 2.6-5.0 CM", "code_information": [{"code": "12013", "type": "CPT"}, {"code": "117051", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 709.0, "discounted_cash": 141.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12014 SMPL REP F/E/E/N/L/MM; 5.1-7.5 CM", "code_information": [{"code": "12014", "type": "CPT"}, {"code": "117053", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 593.0, "discounted_cash": 118.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12015 SMPL REP F/E/E/N/L/MM; 7.6-12.5 CM", "code_information": [{"code": "12015", "type": "CPT"}, {"code": "117055", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 718.0, "discounted_cash": 143.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12016 SMPL REP F/E/E/N/L/MM; 12.6-20.0 CM", "code_information": [{"code": "12016", "type": "CPT"}, {"code": "117057", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 906.0, "discounted_cash": 181.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12021 TX SUPERFICIAL WOUND DEHISCENCE W/PACKING", "code_information": [{"code": "12021", "type": "CPT"}, {"code": "117065", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 733.0, "discounted_cash": 146.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12031 LAC. REP. INTERMED </=2.5 CM", "code_information": [{"code": "12031", "type": "CPT"}, {"code": "117067", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1061.0, "discounted_cash": 212.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12032 LAC. RPR, INTERMED 2.6-7.5 CM", "code_information": [{"code": "12032", "type": "CPT"}, {"code": "117069", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1314.0, "discounted_cash": 262.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12034 LAC. RPR, INTERMED 7.6-12.5 CM", "code_information": [{"code": "12034", "type": "CPT"}, {"code": "117071", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1379.0, "discounted_cash": 275.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12035 LAC. RPR, INTERMED 12.6-20.0 CM", "code_information": [{"code": "12035", "type": "CPT"}, {"code": "117073", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1661.0, "discounted_cash": 332.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12036 LAC. RPR, INTERMED 20.1-30.0 CM", "code_information": [{"code": "12036", "type": "CPT"}, {"code": "117075", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1840.0, "discounted_cash": 368.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12037 LAC. REPAIR INTERMED > 30CM", "code_information": [{"code": "12037", "type": "CPT"}, {"code": "117077", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2083.0, "discounted_cash": 416.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12041 LAC. REP, INTERMED </=2.5 CM", "code_information": [{"code": "12041", "type": "CPT"}, {"code": "117079", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1060.0, "discounted_cash": 212.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12042 LAYER CLOSURE,WOUND 2.6-7.5CM", "code_information": [{"code": "12042", "type": "CPT"}, {"code": "117081", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1281.0, "discounted_cash": 256.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12044 LAC. RPR, INTERMED 7.6-12.5 CM", "code_information": [{"code": "12044", "type": "CPT"}, {"code": "162830", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1582.0, "discounted_cash": 316.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12045 RPR INTMD WND N-HG/GENITALIA", "code_information": [{"code": "12045", "type": "CPT"}, {"code": "117083", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1743.0, "discounted_cash": 348.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12047 INTERM LAC OVER 30.0CM", "code_information": [{"code": "12047", "type": "CPT"}, {"code": "117087", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2304.0, "discounted_cash": 460.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12051 LAC. REPAIR, INTERMED F/E/E/N/L&/MUC </=2.5 CM", "code_information": [{"code": "12051", "type": "CPT"}, {"code": "117089", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1148.0, "discounted_cash": 229.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12052 LAC. RPR, INTERMED 2.6-5.0 CM", "code_information": [{"code": "12052", "type": "CPT"}, {"code": "117091", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1301.0, "discounted_cash": 260.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12053 LAC. RPR, INTERMED 5.1-7.5 CM", "code_information": [{"code": "12053", "type": "CPT"}, {"code": "117093", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1521.0, "discounted_cash": 304.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12054 LAC. RPR, INTERMED 7.6-12.5CM", "code_information": [{"code": "12054", "type": "CPT"}, {"code": "117095", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1593.0, "discounted_cash": 318.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12055 LAC. RPR, INTERMED 12.6-20.0 C", "code_information": [{"code": "12055", "type": "CPT"}, {"code": "162832", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2064.0, "discounted_cash": 412.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 12057 LAC. REPAIR INTERMED >30CM", "code_information": [{"code": "12057", "type": "CPT"}, {"code": "117099", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2590.0, "discounted_cash": 518.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13100 LAC. COMPLEX TRUNK 1.1-2.5CM", "code_information": [{"code": "13100", "type": "CPT"}, {"code": "117101", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1469.0, "discounted_cash": 293.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13101 LAC. COMPLEX TRUNK 2.6-7.5CM", "code_information": [{"code": "13101", "type": "CPT"}, {"code": "117103", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1732.0, "discounted_cash": 346.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13102 LAC. CMPLX TRUNK;EA ADDL 5CM/<", "code_information": [{"code": "13102", "type": "CPT"}, {"code": "117105", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 527.0, "discounted_cash": 105.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13120 LAC. SCALP, ARMS, LEGS 1.1-2.5", "code_information": [{"code": "13120", "type": "CPT"}, {"code": "117107", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1535.0, "discounted_cash": 307.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13121 LAC. SCALP, ARMS. LEGS 2.6-7.5", "code_information": [{"code": "13121", "type": "CPT"}, {"code": "117109", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1866.0, "discounted_cash": 373.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13122 REPAIR,COMPLX EA ADD 5CM OR LE", "code_information": [{"code": "13122", "type": "CPT"}, {"code": "117111", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 576.0, "discounted_cash": 115.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13131 LAC CHEEKS,CHIN,MOUTH, 1.1-2.5", "code_information": [{"code": "13131", "type": "CPT"}, {"code": "117113", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1689.0, "discounted_cash": 337.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13132 LAC. CHEEKS,CHIN,MOUTH 2.6-7.5", "code_information": [{"code": "13132", "type": "CPT"}, {"code": "117117", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2080.0, "discounted_cash": 416.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13133 CREP H/A/G/EXTR; EA ADD 5 CM/<", "code_information": [{"code": "13133", "type": "CPT"}, {"code": "117119", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 774.0, "discounted_cash": 154.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13151 LAC. EYE,NOSE,EARS 1.1-2.5CM", "code_information": [{"code": "13151", "type": "CPT"}, {"code": "117125", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1849.0, "discounted_cash": 369.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13152 LAC. EYE, NOSE, EARS 2.6-7.5CM", "code_information": [{"code": "13152", "type": "CPT"}, {"code": "117127", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2207.0, "discounted_cash": 441.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 13153 LAC EYE,NOSE,EARS, EA ADD 5CM<", "code_information": [{"code": "13153", "type": "CPT"}, {"code": "117129", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 840.0, "discounted_cash": 168.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 14020 TISSUE XFER-TRUNK <=10 SQ CM", "code_information": [{"code": "14020", "type": "CPT"}, {"code": "117133", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 3026.0, "discounted_cash": 605.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 15853 RMVL SUTURES/STAPLES NOT REQUIRING ANES", "code_information": [{"code": "15853", "type": "CPT"}, {"code": "249448", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 46.0, "discounted_cash": 9.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 15854 RMVL SUTURES&STAPLES NOT REQ ANES", "code_information": [{"code": "15854", "type": "CPT"}, {"code": "249809", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 74.0, "discounted_cash": 14.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 16020 DRS&/DBRDMT P-THKNS BURN 1ST/SM", "code_information": [{"code": "16020", "type": "CPT"}, {"code": "117145", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 354.0, "discounted_cash": 70.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 16035 ESCHAROTOMY", "code_information": [{"code": "16035", "type": "CPT"}, {"code": "117151", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1312.0, "discounted_cash": 262.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 17110 DEST B9 LESIONS UP TO 14", "code_information": [{"code": "17110", "type": "CPT"}, {"code": "117159", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 95.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 17999 UNLISTED PX SKIN MUC MEMBRANE &SUBQ TISSUE", "code_information": [{"code": "17999", "type": "CPT"}, {"code": "117181", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 400.0, "discounted_cash": 80.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19000 PUNCTURE ASPIRATION CYST BREAST", "code_information": [{"code": "19000", "type": "CPT"}, {"code": "117183", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 475.0, "discounted_cash": 95.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19001 PUNCTURE ASPIRATION BREAST EA ADDL CYST", "code_information": [{"code": "19001", "type": "CPT"}, {"code": "117185", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 131.0, "discounted_cash": 26.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19020 MASTOTOMY W/EXPL/DRAINAGE ABSCESS DEEP", "code_information": [{"code": "19020", "type": "CPT"}, {"code": "117187", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2044.0, "discounted_cash": 408.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19030 INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM", "code_information": [{"code": "19030", "type": "CPT"}, {"code": "117189", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 724.0, "discounted_cash": 144.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19081 STEREOTAC BX BRST 1ST LES", "code_information": [{"code": "19081", "type": "CPT"}, {"code": "176477", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 2491.0, "discounted_cash": 498.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19082 STEREOTAC BX BRST EA ADDL LES", "code_information": [{"code": "19082", "type": "CPT"}, {"code": "176479", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 2027.0, "discounted_cash": 405.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19083 US BX BRST 1ST LES", "code_information": [{"code": "19083", "type": "CPT"}, {"code": "176481", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 2439.0, "discounted_cash": 487.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19084 US BX BRST EA ADDL LES", "code_information": [{"code": "19084", "type": "CPT"}, {"code": "176483", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 1953.0, "discounted_cash": 390.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19085 MRI BX BRST 1ST LES", "code_information": [{"code": "19085", "type": "CPT"}, {"code": "177315", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 3697.0, "discounted_cash": 739.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19281 MG PLCMT PERQ DEV BREAST 1ST LES", "code_information": [{"code": "19281", "type": "CPT"}, {"code": "176485", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 940.0, "discounted_cash": 188.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19282 MG PLCMT PERQ DEV BREAST EA ADDL LES", "code_information": [{"code": "19282", "type": "CPT"}, {"code": "176487", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 386.0, "discounted_cash": 77.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19285 US PLCMT PERQ DEV BREAST 1ST LES", "code_information": [{"code": "19285", "type": "CPT"}, {"code": "176493", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 1860.0, "discounted_cash": 372.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 19286 US PLCMT PERQ DEV BREAST EA ADDL LES", "code_information": [{"code": "19286", "type": "CPT"}, {"code": "176495", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 1602.0, "discounted_cash": 320.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 20100 EXPLORATION PENETRATING WOUND SPX NECK", "code_information": [{"code": "20100", "type": "CPT"}, {"code": "117217", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2685.0, "discounted_cash": 537.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 20101 EXPLORATION PENETRATING WOUND SPX CHEST", "code_information": [{"code": "20101", "type": "CPT"}, {"code": "117219", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1960.0, "discounted_cash": 392.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 20525 REM FB MUSCL/TENDON;DEEP/COMPL", "code_information": [{"code": "20525", "type": "CPT"}, {"code": "117233", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2066.0, "discounted_cash": 413.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 20550 INJ(S) SGL TENDON SHTH/LIGMNT", "code_information": [{"code": "20550", "type": "CPT"}, {"code": "117235", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 233.0, "discounted_cash": 46.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 20552 INJ SGL/MUL-TRIGGER PT,1-2 MUSL(S)", "code_information": [{"code": "20552", "type": "CPT"}, {"code": "117237", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 241.0, "discounted_cash": 48.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 20600 ASP/INJ SMALL JOINT OR BURSA", "code_information": [{"code": "20600", "type": "CPT"}, {"code": "117241", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 212.0, "discounted_cash": 42.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 20605 ASP/INJ INTMED JOINT OR BURSA", "code_information": [{"code": "20605", "type": "CPT"}, {"code": "117243", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 239.0, "discounted_cash": 47.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 20610 ASP/INJ MAJOR JOINT OR BURSA", "code_information": [{"code": "20610", "type": "CPT"}, {"code": "117245", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 287.0, "discounted_cash": 57.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 20612 ASP/INJ GANGLION CYST", "code_information": [{"code": "20612", "type": "CPT"}, {"code": "117247", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 263.0, "discounted_cash": 52.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 20950 MONITOR INTERST FLD PRESSURE", "code_information": [{"code": "20950", "type": "CPT"}, {"code": "117249", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1119.0, "discounted_cash": 223.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 21337 CLSD TX NASAL SEPTAL FX W/WO MANIPULATION", "code_information": [{"code": "21337", "type": "CPT"}, {"code": "199977", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1765.0, "discounted_cash": 353.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 21421 CLSD TX PALATAL/MAXILARRY FX", "code_information": [{"code": "21421", "type": "CPT"}, {"code": "117263", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2888.0, "discounted_cash": 577.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 21440 CLSD TX DENTAL RIDGE FX", "code_information": [{"code": "21440", "type": "CPT"}, {"code": "177399", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 2343.0, "discounted_cash": 468.6, "setting": "outpatient", "billing_class": "facility"}]}, 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264.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 27781 CLST TMT PROX FIB/SHFT FX;W MANJ", "code_information": [{"code": "27781", "type": "CPT"}, {"code": "202741", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1872.0, "discounted_cash": 374.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 27786 CLTX DSTL FIBULAR FX LAT MALLS W/O MNPJ", "code_information": [{"code": "27786", "type": "CPT"}, {"code": "117531", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1365.0, "discounted_cash": 273.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 27788 CLTX DSTL FIBULAR FX LAT MALLS W/MNPJ", "code_information": [{"code": "27788", "type": "CPT"}, {"code": "117533", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1843.0, "discounted_cash": 368.6, "setting": "outpatient", 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"type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 1125.0, "discounted_cash": 225.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 28490 CLTX FX GRT TOE PHLX/PHLG W/O MNPJ", "code_information": [{"code": "28490", "type": "CPT"}, {"code": "117577", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 627.0, "discounted_cash": 125.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 28495 CLTX FX GRT TOE PHLX/PHLG W/MNPJ", "code_information": [{"code": "28495", "type": "CPT"}, {"code": "117579", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 783.0, "discounted_cash": 156.6, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 28510 CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MNPJ", "code_information": [{"code": "28510", "type": "CPT"}, {"code": "117581", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 536.0, "discounted_cash": 107.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 28515 CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MNPJ", "code_information": [{"code": "28515", "type": "CPT"}, {"code": "117583", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 712.0, "discounted_cash": 142.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 28530 CLOSED TREATMENT SESAMOID FRACTURE", "code_information": [{"code": "28530", "type": "CPT"}, {"code": "117585", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": [{"gross_charge": 510.0, "discounted_cash": 102.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 28540 CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES", "code_information": [{"code": "28540", "type": "CPT"}, {"code": "117587", "type": "CDM"}, {"code": "981", "type": "RC"}], "standard_charges": 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55.0, "discounted_cash": 11.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 87177 OVA AND PARASITES SMEARS", "code_information": [{"code": "87177", "type": "CPT"}, {"code": "119523", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 89.0, "discounted_cash": 17.8, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 87184 MICROBE SUSCEPTIBLE, DISK", "code_information": [{"code": "87184", "type": "CPT"}, {"code": "302100", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 85.0, "discounted_cash": 17.0, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 87186 MICROBE SUSCEPTIBLE, MIC", "code_information": [{"code": "87186", "type": "CPT"}, {"code": "302102", "type": "CDM"}, {"code": "300", "type": "RC"}], "standard_charges": [{"gross_charge": 106.0, "discounted_cash": 21.2, "setting": "outpatient", "billing_class": 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PULSE OXIMETER, SINGLE DET", "code_information": [{"code": "94760", "type": "CPT"}, {"code": "119759", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 86.0, "discounted_cash": 17.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 94761 PULSE OXIMETER, MULTIPLE DET", "code_information": [{"code": "94761", "type": "CPT"}, {"code": "119761", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 177.0, "discounted_cash": 35.4, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 96365 IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST UP TO 1 HOUR", "code_information": [{"code": "96365", "type": "CPT"}, {"code": "119769", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 246.0, "discounted_cash": 49.2, "setting": "outpatient", "billing_class": "facility"}]}, {"description": "HC PHY 96372 INJ,ADMIN THER/PROPH/DG;SC/IM", 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534.0, "discounted_cash": 106.8, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "25"}, {"description": "HC PHY 99203 OFC/OUTPATIENT VISIT,NEW 3", "code_information": [{"code": "99203", "type": "CPT"}, {"code": "119815", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 670.0, "discounted_cash": 134.0, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "25"}, {"description": "HC PHY 99204 OFC/OUTPATIENT VISIT,NEW 4", "code_information": [{"code": "99204", "type": "CPT"}, {"code": "119817", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 852.0, "discounted_cash": 170.4, "setting": "outpatient", "billing_class": "facility"}], "modifiers": "25"}, {"description": "HC PHY 99205 OFC/OUTPATIENT VISIT,NEW 5", "code_information": [{"code": "99205", "type": "CPT"}, {"code": "119819", "type": "CDM"}, {"code": "960", "type": "RC"}], "standard_charges": [{"gross_charge": 1070.0, 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