{ "root": { "HospitalorFacilityName": "White River Medical Center", "PricesPostedandEffective": "1/2/2021", "Notes": "", "StandardCharges": [ { "Description": "ANESTH PROCEDURE ON MOUTH", "ProcedureCode": "00170", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "9546.58", "EmergencyRoomGrossCharge": "9546.58", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "4677.8242", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "8400.9904", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "8400.9904", "AETNA_EmergencyRoom": "8400.9904", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "8400.9904", "AETNAOTHER_EmergencyRoom": "8400.9904", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "5346.0848", "QUALCHOICE_EmergencyRoom": "5346.0848", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "8400.9904", "WEBTPAAetnaNonemployee_EmergencyRoom": "8400.9904", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "ANESTH INTRCRN NERVE", "ProcedureCode": "00220", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "21.00", "EmergencyRoomGrossCharge": "21.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "10.2900", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "18.4800", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "18.4800", "AETNA_EmergencyRoom": "18.4800", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "18.4800", "AETNAOTHER_EmergencyRoom": "18.4800", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "11.7600", "QUALCHOICE_EmergencyRoom": "11.7600", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "18.4800", "WEBTPAAetnaNonemployee_EmergencyRoom": "18.4800", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "HOSP MANAGE CONT DRUG ADMIN", "ProcedureCode": "01996", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "255.00", "EmergencyRoomGrossCharge": "255.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "124.9500", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "224.4000", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "224.4000", "AETNA_EmergencyRoom": "224.4000", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "224.4000", "AETNAOTHER_EmergencyRoom": "224.4000", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "142.8000", "QUALCHOICE_EmergencyRoom": "142.8000", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "224.4000", "WEBTPAAetnaNonemployee_EmergencyRoom": "224.4000", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "FNA BX W/O IMG GDN EA ADDL", "ProcedureCode": "10004", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "544.00", "EmergencyRoomGrossCharge": "544.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "266.5600", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "478.7200", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "478.7200", "AETNA_EmergencyRoom": "478.7200", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "478.7200", "AETNAOTHER_EmergencyRoom": "478.7200", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "304.6400", "QUALCHOICE_EmergencyRoom": "304.6400", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "478.7200", "WEBTPAAetnaNonemployee_EmergencyRoom": "478.7200", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "FNA BX W/US GDN 1ST LES", "ProcedureCode": "10005", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "2599.00", "EmergencyRoomGrossCharge": "2599.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "1273.5100", "MinimumNegotiatedCharge": "609.74", "MaximumNegotiatedCharge": "2287.1200", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "2287.1200", "AETNA_EmergencyRoom": "2287.1200", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "2287.1200", "AETNAOTHER_EmergencyRoom": "2287.1200", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "1455.4400", "QUALCHOICE_EmergencyRoom": "1455.4400", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "2287.1200", "WEBTPAAetnaNonemployee_EmergencyRoom": "2287.1200", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "FNA BX W/US GDN EA ADDL", "ProcedureCode": "10006", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1405.00", "EmergencyRoomGrossCharge": "1405.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "688.4500", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "1236.4000", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "1236.4000", "AETNA_EmergencyRoom": "1236.4000", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "1236.4000", "AETNAOTHER_EmergencyRoom": "1236.4000", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "786.8000", "QUALCHOICE_EmergencyRoom": "786.8000", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "1236.4000", "WEBTPAAetnaNonemployee_EmergencyRoom": "1236.4000", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "FNA BX W/FLUOR GDN 1ST LES", "ProcedureCode": "10007", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1405.00", "EmergencyRoomGrossCharge": "1405.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "688.4500", "MinimumNegotiatedCharge": "609.74", "MaximumNegotiatedCharge": "1236.4000", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "1236.4000", "AETNA_EmergencyRoom": "1236.4000", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "1236.4000", "AETNAOTHER_EmergencyRoom": "1236.4000", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "786.8000", "QUALCHOICE_EmergencyRoom": "786.8000", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "1236.4000", "WEBTPAAetnaNonemployee_EmergencyRoom": "1236.4000", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "FNA BX W/FLUOR GDN EA ADDL", "ProcedureCode": "10008", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1405.00", "EmergencyRoomGrossCharge": "1405.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "688.4500", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "1236.4000", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "1236.4000", "AETNA_EmergencyRoom": "1236.4000", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "1236.4000", "AETNAOTHER_EmergencyRoom": "1236.4000", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "786.8000", "QUALCHOICE_EmergencyRoom": "786.8000", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "1236.4000", "WEBTPAAetnaNonemployee_EmergencyRoom": "1236.4000", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "FNA BX W/CT GDN 1ST LES", "ProcedureCode": "10009", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1405.00", "EmergencyRoomGrossCharge": "1405.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "688.4500", "MinimumNegotiatedCharge": "609.74", "MaximumNegotiatedCharge": "1236.4000", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "1236.4000", "AETNA_EmergencyRoom": "1236.4000", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "1236.4000", "AETNAOTHER_EmergencyRoom": "1236.4000", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "786.8000", "QUALCHOICE_EmergencyRoom": "786.8000", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "1236.4000", "WEBTPAAetnaNonemployee_EmergencyRoom": "1236.4000", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "FNA BX W/CT GDN EA ADDL", "ProcedureCode": "10010", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1405.00", "EmergencyRoomGrossCharge": "1405.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "688.4500", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "1236.4000", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "1236.4000", "AETNA_EmergencyRoom": "1236.4000", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "1236.4000", "AETNAOTHER_EmergencyRoom": "1236.4000", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "786.8000", "QUALCHOICE_EmergencyRoom": "786.8000", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "1236.4000", "WEBTPAAetnaNonemployee_EmergencyRoom": "1236.4000", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "FNA BX W/MR GDN 1ST LES", "ProcedureCode": "10011", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1405.00", "EmergencyRoomGrossCharge": "1405.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "688.4500", "MinimumNegotiatedCharge": "609.74", "MaximumNegotiatedCharge": "1236.4000", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "1236.4000", "AETNA_EmergencyRoom": "1236.4000", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "1236.4000", "AETNAOTHER_EmergencyRoom": "1236.4000", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "786.8000", "QUALCHOICE_EmergencyRoom": "786.8000", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "1236.4000", "WEBTPAAetnaNonemployee_EmergencyRoom": "1236.4000", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "FNA BX W/MR GDN EA ADDL", "ProcedureCode": "10012", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1405.00", "EmergencyRoomGrossCharge": "1405.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "688.4500", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "1236.4000", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "1236.4000", "AETNA_EmergencyRoom": "1236.4000", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "1236.4000", "AETNAOTHER_EmergencyRoom": "1236.4000", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "786.8000", "QUALCHOICE_EmergencyRoom": "786.8000", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "1236.4000", "WEBTPAAetnaNonemployee_EmergencyRoom": "1236.4000", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "FNA BX W/O IMG GDN 1ST LES", "ProcedureCode": "10021", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "2599.00", "EmergencyRoomGrossCharge": "2599.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "1273.5100", "MinimumNegotiatedCharge": "339.04", "MaximumNegotiatedCharge": "2287.1200", "AARPMedicareManagedCare_OPPS": "339.04", "ADVANTRAFREEDOM_OPPS": "339.04", "AETNA_Outpatient": "2287.1200", "AETNA_EmergencyRoom": "2287.1200", "AETNAMEDICAREADVANTAGE_OPPS": "339.04", "AETNAOTHER_Outpatient": "2287.1200", "AETNAOTHER_EmergencyRoom": "2287.1200", "Allwell_OPPS": "339.04", "Amerigroup_OPPS": "339.04", "ARKANSASCOMMUNITYCARE_OPPS": "339.04", "Cigna-Healthspring_OPPS": "339.04", "GOLDENRULEINSCO_OPPS": "339.04", "HUMANACHOICEPPO_OPPS": "339.04", "HUMANAGOLD(MCRHMO)_OPPS": "339.04", "HUMANAGOLDPFFS_OPPS": "339.04", "MEDICARE_OPPS": "339.04", "MedicareAdvantageOther_OPPS": "339.04", "MedicareRailroad_OPPS": "339.04", "MEDIPAK_OPPS": "339.04", "MEDIPAKADVANTAGE_OPPS": "339.04", "MVPHEALTHCARE_OPPS": "339.04", "PYRAMID/MCRHMO_OPPS": "339.04", "QUALCHOICE_Outpatient": "1455.4400", "QUALCHOICE_EmergencyRoom": "1455.4400", "SECUREHORIZONS_OPPS": "339.04", "STERLINGOPTIONONE,STER_OPPS": "339.04", "TributeHealthPlan_OPPS": "339.04", "TRICAREEAST_OPPS": "339.04", "TRICAREFORLIFE_OPPS": "339.04", "TRICAREWEST_OPPS": "339.04", "UMR_OPPS": "339.04", "UNITEDHCOFRIVERVALLEY_OPPS": "339.04", "UNITEDHEALTHCARE_OPPS": "339.04", "UNITEDHEALTHCAREADVANTAGE_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+GA_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+UT_OPPS": "339.04", "UNITEDHEALTHCAREOTHER_OPPS": "339.04", "UnitedHealthcareSharedServ._OPPS": "339.04", "VACHAMPVA_OPPS": "339.04", "WEBTPAAetnaNonemployee_Outpatient": "2287.1200", "WEBTPAAetnaNonemployee_EmergencyRoom": "2287.1200", "WELLCAREHEALTHPLANS_OPPS": "339.04" }, { "Description": "GUIDE CATHET FLUID DRAINAGE", "ProcedureCode": "10030", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "5765.61", "EmergencyRoomGrossCharge": "5765.61", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "2825.1489", "MinimumNegotiatedCharge": "609.74", "MaximumNegotiatedCharge": "5073.7368", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "5073.7368", "AETNA_EmergencyRoom": "5073.7368", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "5073.7368", "AETNAOTHER_EmergencyRoom": "5073.7368", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "3228.7416", "QUALCHOICE_EmergencyRoom": "3228.7416", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "5073.7368", "WEBTPAAetnaNonemployee_EmergencyRoom": "5073.7368", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "DRAINAGE OF SKIN ABSCESS", "ProcedureCode": "10060", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "11506.95", "EmergencyRoomGrossCharge": "11506.95", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "5638.4055", "MinimumNegotiatedCharge": "176.02", "MaximumNegotiatedCharge": "10126.1160", "AARPMedicareManagedCare_OPPS": "176.02", "ADVANTRAFREEDOM_OPPS": "176.02", "AETNA_Outpatient": "10126.1160", "AETNA_EmergencyRoom": "10126.1160", "AETNAMEDICAREADVANTAGE_OPPS": "176.02", "AETNAOTHER_Outpatient": "10126.1160", "AETNAOTHER_EmergencyRoom": "10126.1160", "Allwell_OPPS": "176.02", "Amerigroup_OPPS": "176.02", "ARKANSASCOMMUNITYCARE_OPPS": "176.02", "Cigna-Healthspring_OPPS": "176.02", "GOLDENRULEINSCO_OPPS": "176.02", "HUMANACHOICEPPO_OPPS": "176.02", "HUMANAGOLD(MCRHMO)_OPPS": "176.02", "HUMANAGOLDPFFS_OPPS": "176.02", "MEDICARE_OPPS": "176.02", "MedicareAdvantageOther_OPPS": "176.02", "MedicareRailroad_OPPS": "176.02", "MEDIPAK_OPPS": "176.02", "MEDIPAKADVANTAGE_OPPS": "176.02", "MVPHEALTHCARE_OPPS": "176.02", "PYRAMID/MCRHMO_OPPS": "176.02", "QUALCHOICE_Outpatient": "6443.8920", "QUALCHOICE_EmergencyRoom": "6443.8920", "SECUREHORIZONS_OPPS": "176.02", "STERLINGOPTIONONE,STER_OPPS": "176.02", "TributeHealthPlan_OPPS": "176.02", "TRICAREEAST_OPPS": "176.02", "TRICAREFORLIFE_OPPS": "176.02", "TRICAREWEST_OPPS": "176.02", "UMR_OPPS": "176.02", "UNITEDHCOFRIVERVALLEY_OPPS": "176.02", "UNITEDHEALTHCARE_OPPS": "176.02", "UNITEDHEALTHCAREADVANTAGE_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+GA_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+UT_OPPS": "176.02", "UNITEDHEALTHCAREOTHER_OPPS": "176.02", "UnitedHealthcareSharedServ._OPPS": "176.02", "VACHAMPVA_OPPS": "176.02", "WEBTPAAetnaNonemployee_Outpatient": "10126.1160", "WEBTPAAetnaNonemployee_EmergencyRoom": "10126.1160", "WELLCAREHEALTHPLANS_OPPS": "176.02" }, { "Description": "DRAINAGE OF SKIN ABSCESS", "ProcedureCode": "10061", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "472.00", "EmergencyRoomGrossCharge": "472.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "231.2800", "MinimumNegotiatedCharge": "264.3200", "MaximumNegotiatedCharge": "415.3600", "AARPMedicareManagedCare_OPPS": "339.04", "ADVANTRAFREEDOM_OPPS": "339.04", "AETNA_Outpatient": "415.3600", "AETNA_EmergencyRoom": "415.3600", "AETNAMEDICAREADVANTAGE_OPPS": "339.04", "AETNAOTHER_Outpatient": "415.3600", "AETNAOTHER_EmergencyRoom": "415.3600", "Allwell_OPPS": "339.04", "Amerigroup_OPPS": "339.04", "ARKANSASCOMMUNITYCARE_OPPS": "339.04", "Cigna-Healthspring_OPPS": "339.04", "GOLDENRULEINSCO_OPPS": "339.04", "HUMANACHOICEPPO_OPPS": "339.04", "HUMANAGOLD(MCRHMO)_OPPS": "339.04", "HUMANAGOLDPFFS_OPPS": "339.04", "MEDICARE_OPPS": "339.04", "MedicareAdvantageOther_OPPS": "339.04", "MedicareRailroad_OPPS": "339.04", "MEDIPAK_OPPS": "339.04", "MEDIPAKADVANTAGE_OPPS": "339.04", "MVPHEALTHCARE_OPPS": "339.04", "PYRAMID/MCRHMO_OPPS": "339.04", "QUALCHOICE_Outpatient": "264.3200", "QUALCHOICE_EmergencyRoom": "264.3200", "SECUREHORIZONS_OPPS": "339.04", "STERLINGOPTIONONE,STER_OPPS": "339.04", "TributeHealthPlan_OPPS": "339.04", "TRICAREEAST_OPPS": "339.04", "TRICAREFORLIFE_OPPS": "339.04", "TRICAREWEST_OPPS": "339.04", "UMR_OPPS": "339.04", "UNITEDHCOFRIVERVALLEY_OPPS": "339.04", "UNITEDHEALTHCARE_OPPS": "339.04", "UNITEDHEALTHCAREADVANTAGE_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+GA_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+UT_OPPS": "339.04", "UNITEDHEALTHCAREOTHER_OPPS": "339.04", "UnitedHealthcareSharedServ._OPPS": "339.04", "VACHAMPVA_OPPS": "339.04", "WEBTPAAetnaNonemployee_Outpatient": "415.3600", "WEBTPAAetnaNonemployee_EmergencyRoom": "415.3600", "WELLCAREHEALTHPLANS_OPPS": "339.04" }, { "Description": "REMOVE FOREIGN BODY", "ProcedureCode": "10120", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "732.00", "EmergencyRoomGrossCharge": "732.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "358.6800", "MinimumNegotiatedCharge": "339.04", "MaximumNegotiatedCharge": "644.1600", "AARPMedicareManagedCare_OPPS": "339.04", "ADVANTRAFREEDOM_OPPS": "339.04", "AETNA_Outpatient": "644.1600", "AETNA_EmergencyRoom": "644.1600", "AETNAMEDICAREADVANTAGE_OPPS": "339.04", "AETNAOTHER_Outpatient": "644.1600", "AETNAOTHER_EmergencyRoom": "644.1600", "Allwell_OPPS": "339.04", "Amerigroup_OPPS": "339.04", "ARKANSASCOMMUNITYCARE_OPPS": "339.04", "Cigna-Healthspring_OPPS": "339.04", "GOLDENRULEINSCO_OPPS": "339.04", "HUMANACHOICEPPO_OPPS": "339.04", "HUMANAGOLD(MCRHMO)_OPPS": "339.04", "HUMANAGOLDPFFS_OPPS": "339.04", "MEDICARE_OPPS": "339.04", "MedicareAdvantageOther_OPPS": "339.04", "MedicareRailroad_OPPS": "339.04", "MEDIPAK_OPPS": "339.04", "MEDIPAKADVANTAGE_OPPS": "339.04", "MVPHEALTHCARE_OPPS": "339.04", "PYRAMID/MCRHMO_OPPS": "339.04", "QUALCHOICE_Outpatient": "409.9200", "QUALCHOICE_EmergencyRoom": "409.9200", "SECUREHORIZONS_OPPS": "339.04", "STERLINGOPTIONONE,STER_OPPS": "339.04", "TributeHealthPlan_OPPS": "339.04", "TRICAREEAST_OPPS": "339.04", "TRICAREFORLIFE_OPPS": "339.04", "TRICAREWEST_OPPS": "339.04", "UMR_OPPS": "339.04", "UNITEDHCOFRIVERVALLEY_OPPS": "339.04", "UNITEDHEALTHCARE_OPPS": "339.04", "UNITEDHEALTHCAREADVANTAGE_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+GA_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+UT_OPPS": "339.04", "UNITEDHEALTHCAREOTHER_OPPS": "339.04", "UnitedHealthcareSharedServ._OPPS": "339.04", "VACHAMPVA_OPPS": "339.04", "WEBTPAAetnaNonemployee_Outpatient": "644.1600", "WEBTPAAetnaNonemployee_EmergencyRoom": "644.1600", "WELLCAREHEALTHPLANS_OPPS": "339.04" }, { "Description": "DRAINAGE OF HEMATOMA/FLUID", "ProcedureCode": "10140", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "8004.01", "EmergencyRoomGrossCharge": "8004.01", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "3921.9649", "MinimumNegotiatedCharge": "1379.32", "MaximumNegotiatedCharge": "7043.5288", "AARPMedicareManagedCare_OPPS": "1379.32", "ADVANTRAFREEDOM_OPPS": "1379.32", "AETNA_Outpatient": "7043.5288", "AETNA_EmergencyRoom": "7043.5288", "AETNAMEDICAREADVANTAGE_OPPS": "1379.32", "AETNAOTHER_Outpatient": "7043.5288", "AETNAOTHER_EmergencyRoom": "7043.5288", "Allwell_OPPS": "1379.32", "Amerigroup_OPPS": "1379.32", "ARKANSASCOMMUNITYCARE_OPPS": "1379.32", "Cigna-Healthspring_OPPS": "1379.32", "GOLDENRULEINSCO_OPPS": "1379.32", "HUMANACHOICEPPO_OPPS": "1379.32", "HUMANAGOLD(MCRHMO)_OPPS": "1379.32", "HUMANAGOLDPFFS_OPPS": "1379.32", "MEDICARE_OPPS": "1379.32", "MedicareAdvantageOther_OPPS": "1379.32", "MedicareRailroad_OPPS": "1379.32", "MEDIPAK_OPPS": "1379.32", "MEDIPAKADVANTAGE_OPPS": "1379.32", "MVPHEALTHCARE_OPPS": "1379.32", "PYRAMID/MCRHMO_OPPS": "1379.32", "QUALCHOICE_Outpatient": "4482.2456", "QUALCHOICE_EmergencyRoom": "4482.2456", "SECUREHORIZONS_OPPS": "1379.32", "STERLINGOPTIONONE,STER_OPPS": "1379.32", "TributeHealthPlan_OPPS": "1379.32", "TRICAREEAST_OPPS": "1379.32", "TRICAREFORLIFE_OPPS": "1379.32", "TRICAREWEST_OPPS": "1379.32", "UMR_OPPS": "1379.32", "UNITEDHCOFRIVERVALLEY_OPPS": "1379.32", "UNITEDHEALTHCARE_OPPS": "1379.32", "UNITEDHEALTHCAREADVANTAGE_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+GA_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+UT_OPPS": "1379.32", "UNITEDHEALTHCAREOTHER_OPPS": "1379.32", "UnitedHealthcareSharedServ._OPPS": "1379.32", "VACHAMPVA_OPPS": "1379.32", "WEBTPAAetnaNonemployee_Outpatient": "7043.5288", "WEBTPAAetnaNonemployee_EmergencyRoom": "7043.5288", "WELLCAREHEALTHPLANS_OPPS": "1379.32" }, { "Description": "PUNCTURE DRAINAGE OF LESION", "ProcedureCode": "10160", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1826.00", "EmergencyRoomGrossCharge": "1826.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "894.7400", "MinimumNegotiatedCharge": "339.04", "MaximumNegotiatedCharge": "1606.8800", "AARPMedicareManagedCare_OPPS": "339.04", "ADVANTRAFREEDOM_OPPS": "339.04", "AETNA_Outpatient": "1606.8800", "AETNA_EmergencyRoom": "1606.8800", "AETNAMEDICAREADVANTAGE_OPPS": "339.04", "AETNAOTHER_Outpatient": "1606.8800", "AETNAOTHER_EmergencyRoom": "1606.8800", "Allwell_OPPS": "339.04", "Amerigroup_OPPS": "339.04", "ARKANSASCOMMUNITYCARE_OPPS": "339.04", "Cigna-Healthspring_OPPS": "339.04", "GOLDENRULEINSCO_OPPS": "339.04", "HUMANACHOICEPPO_OPPS": "339.04", "HUMANAGOLD(MCRHMO)_OPPS": "339.04", "HUMANAGOLDPFFS_OPPS": "339.04", "MEDICARE_OPPS": "339.04", "MedicareAdvantageOther_OPPS": "339.04", "MedicareRailroad_OPPS": "339.04", "MEDIPAK_OPPS": "339.04", "MEDIPAKADVANTAGE_OPPS": "339.04", "MVPHEALTHCARE_OPPS": "339.04", "PYRAMID/MCRHMO_OPPS": "339.04", "QUALCHOICE_Outpatient": "1022.5600", "QUALCHOICE_EmergencyRoom": "1022.5600", "SECUREHORIZONS_OPPS": "339.04", "STERLINGOPTIONONE,STER_OPPS": "339.04", "TributeHealthPlan_OPPS": "339.04", "TRICAREEAST_OPPS": "339.04", "TRICAREFORLIFE_OPPS": "339.04", "TRICAREWEST_OPPS": "339.04", "UMR_OPPS": "339.04", "UNITEDHCOFRIVERVALLEY_OPPS": "339.04", "UNITEDHEALTHCARE_OPPS": "339.04", "UNITEDHEALTHCAREADVANTAGE_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+GA_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+UT_OPPS": "339.04", "UNITEDHEALTHCAREOTHER_OPPS": "339.04", "UnitedHealthcareSharedServ._OPPS": "339.04", "VACHAMPVA_OPPS": "339.04", "WEBTPAAetnaNonemployee_Outpatient": "1606.8800", "WEBTPAAetnaNonemployee_EmergencyRoom": "1606.8800", "WELLCAREHEALTHPLANS_OPPS": "339.04" }, { "Description": "DEBRIDE SKIN AT FX SITE", "ProcedureCode": "11010", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "34515.83", "EmergencyRoomGrossCharge": "34515.83", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "16912.7567", "MinimumNegotiatedCharge": "609.74", "MaximumNegotiatedCharge": "30373.9304", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "30373.9304", "AETNA_EmergencyRoom": "30373.9304", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "30373.9304", "AETNAOTHER_EmergencyRoom": "30373.9304", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "19328.8648", "QUALCHOICE_EmergencyRoom": "19328.8648", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "30373.9304", "WEBTPAAetnaNonemployee_EmergencyRoom": "30373.9304", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "DEBRIDE SKIN MUSC AT FX SIT", "ProcedureCode": "11011", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1405.00", "EmergencyRoomGrossCharge": "1405.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "688.4500", "MinimumNegotiatedCharge": "609.74", "MaximumNegotiatedCharge": "1236.4000", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "1236.4000", "AETNA_EmergencyRoom": "1236.4000", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "1236.4000", "AETNAOTHER_EmergencyRoom": "1236.4000", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "786.8000", "QUALCHOICE_EmergencyRoom": "786.8000", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "1236.4000", "WEBTPAAetnaNonemployee_EmergencyRoom": "1236.4000", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "DEB SKIN BONE AT FX SITE", "ProcedureCode": "11012", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "9682.14", "EmergencyRoomGrossCharge": "9682.14", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "4744.2486", "MinimumNegotiatedCharge": "2323.39", "MaximumNegotiatedCharge": "8520.2832", "AARPMedicareManagedCare_OPPS": "2323.39", "ADVANTRAFREEDOM_OPPS": "2323.39", "AETNA_Outpatient": "8520.2832", "AETNA_EmergencyRoom": "8520.2832", "AETNAMEDICAREADVANTAGE_OPPS": "2323.39", "AETNAOTHER_Outpatient": "8520.2832", "AETNAOTHER_EmergencyRoom": "8520.2832", "Allwell_OPPS": "2323.39", "Amerigroup_OPPS": "2323.39", "ARKANSASCOMMUNITYCARE_OPPS": "2323.39", "Cigna-Healthspring_OPPS": "2323.39", "GOLDENRULEINSCO_OPPS": "2323.39", "HUMANACHOICEPPO_OPPS": "2323.39", "HUMANAGOLD(MCRHMO)_OPPS": "2323.39", "HUMANAGOLDPFFS_OPPS": "2323.39", "MEDICARE_OPPS": "2323.39", "MedicareAdvantageOther_OPPS": "2323.39", "MedicareRailroad_OPPS": "2323.39", "MEDIPAK_OPPS": "2323.39", "MEDIPAKADVANTAGE_OPPS": "2323.39", "MVPHEALTHCARE_OPPS": "2323.39", "PYRAMID/MCRHMO_OPPS": "2323.39", "QUALCHOICE_Outpatient": "5421.9984", "QUALCHOICE_EmergencyRoom": "5421.9984", "SECUREHORIZONS_OPPS": "2323.39", "STERLINGOPTIONONE,STER_OPPS": "2323.39", "TributeHealthPlan_OPPS": "2323.39", "TRICAREEAST_OPPS": "2323.39", "TRICAREFORLIFE_OPPS": "2323.39", "TRICAREWEST_OPPS": "2323.39", "UMR_OPPS": "2323.39", "UNITEDHCOFRIVERVALLEY_OPPS": "2323.39", "UNITEDHEALTHCARE_OPPS": "2323.39", "UNITEDHEALTHCAREADVANTAGE_OPPS": "2323.39", "UNITEDHEALTHCARECHOICE+GA_OPPS": "2323.39", "UNITEDHEALTHCARECHOICE+UT_OPPS": "2323.39", "UNITEDHEALTHCAREOTHER_OPPS": "2323.39", "UnitedHealthcareSharedServ._OPPS": "2323.39", "VACHAMPVA_OPPS": "2323.39", "WEBTPAAetnaNonemployee_Outpatient": "8520.2832", "WEBTPAAetnaNonemployee_EmergencyRoom": "8520.2832", "WELLCAREHEALTHPLANS_OPPS": "2323.39" }, { "Description": "DEB SUBQ TISSUE 20 SQ CM/<", "ProcedureCode": "11042", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "8412.01", "EmergencyRoomGrossCharge": "8412.01", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "4121.8849", "MinimumNegotiatedCharge": "339.04", "MaximumNegotiatedCharge": "7402.5688", "AARPMedicareManagedCare_OPPS": "339.04", "ADVANTRAFREEDOM_OPPS": "339.04", "AETNA_Outpatient": "7402.5688", "AETNA_EmergencyRoom": "7402.5688", "AETNAMEDICAREADVANTAGE_OPPS": "339.04", "AETNAOTHER_Outpatient": "7402.5688", "AETNAOTHER_EmergencyRoom": "7402.5688", "Allwell_OPPS": "339.04", "Amerigroup_OPPS": "339.04", "ARKANSASCOMMUNITYCARE_OPPS": "339.04", "Cigna-Healthspring_OPPS": "339.04", "GOLDENRULEINSCO_OPPS": "339.04", "HUMANACHOICEPPO_OPPS": "339.04", "HUMANAGOLD(MCRHMO)_OPPS": "339.04", "HUMANAGOLDPFFS_OPPS": "339.04", "MEDICARE_OPPS": "339.04", "MedicareAdvantageOther_OPPS": "339.04", "MedicareRailroad_OPPS": "339.04", "MEDIPAK_OPPS": "339.04", "MEDIPAKADVANTAGE_OPPS": "339.04", "MVPHEALTHCARE_OPPS": "339.04", "PYRAMID/MCRHMO_OPPS": "339.04", "QUALCHOICE_Outpatient": "4710.7256", "QUALCHOICE_EmergencyRoom": "4710.7256", "SECUREHORIZONS_OPPS": "339.04", "STERLINGOPTIONONE,STER_OPPS": "339.04", "TributeHealthPlan_OPPS": "339.04", "TRICAREEAST_OPPS": "339.04", "TRICAREFORLIFE_OPPS": "339.04", "TRICAREWEST_OPPS": "339.04", "UMR_OPPS": "339.04", "UNITEDHCOFRIVERVALLEY_OPPS": "339.04", "UNITEDHEALTHCARE_OPPS": "339.04", "UNITEDHEALTHCAREADVANTAGE_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+GA_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+UT_OPPS": "339.04", "UNITEDHEALTHCAREOTHER_OPPS": "339.04", "UnitedHealthcareSharedServ._OPPS": "339.04", "VACHAMPVA_OPPS": "339.04", "WEBTPAAetnaNonemployee_Outpatient": "7402.5688", "WEBTPAAetnaNonemployee_EmergencyRoom": "7402.5688", "WELLCAREHEALTHPLANS_OPPS": "339.04" }, { "Description": "DEB MUSC/FASCIA 20 SQ CM/<", "ProcedureCode": "11043", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "15584.61", "EmergencyRoomGrossCharge": "15584.61", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "7636.4589", "MinimumNegotiatedCharge": "513.86", "MaximumNegotiatedCharge": "13714.4568", "AARPMedicareManagedCare_OPPS": "513.86", "ADVANTRAFREEDOM_OPPS": "513.86", "AETNA_Outpatient": "13714.4568", "AETNA_EmergencyRoom": "13714.4568", "AETNAMEDICAREADVANTAGE_OPPS": "513.86", "AETNAOTHER_Outpatient": "13714.4568", "AETNAOTHER_EmergencyRoom": "13714.4568", "Allwell_OPPS": "513.86", "Amerigroup_OPPS": "513.86", "ARKANSASCOMMUNITYCARE_OPPS": "513.86", "Cigna-Healthspring_OPPS": "513.86", "GOLDENRULEINSCO_OPPS": "513.86", "HUMANACHOICEPPO_OPPS": "513.86", "HUMANAGOLD(MCRHMO)_OPPS": "513.86", "HUMANAGOLDPFFS_OPPS": "513.86", "MEDICARE_OPPS": "513.86", "MedicareAdvantageOther_OPPS": "513.86", "MedicareRailroad_OPPS": "513.86", "MEDIPAK_OPPS": "513.86", "MEDIPAKADVANTAGE_OPPS": "513.86", "MVPHEALTHCARE_OPPS": "513.86", "PYRAMID/MCRHMO_OPPS": "513.86", "QUALCHOICE_Outpatient": "8727.3816", "QUALCHOICE_EmergencyRoom": "8727.3816", "SECUREHORIZONS_OPPS": "513.86", "STERLINGOPTIONONE,STER_OPPS": "513.86", "TributeHealthPlan_OPPS": "513.86", "TRICAREEAST_OPPS": "513.86", "TRICAREFORLIFE_OPPS": "513.86", "TRICAREWEST_OPPS": "513.86", "UMR_OPPS": "513.86", "UNITEDHCOFRIVERVALLEY_OPPS": "513.86", "UNITEDHEALTHCARE_OPPS": "513.86", "UNITEDHEALTHCAREADVANTAGE_OPPS": "513.86", "UNITEDHEALTHCARECHOICE+GA_OPPS": "513.86", "UNITEDHEALTHCARECHOICE+UT_OPPS": "513.86", "UNITEDHEALTHCAREOTHER_OPPS": "513.86", "UnitedHealthcareSharedServ._OPPS": "513.86", "VACHAMPVA_OPPS": "513.86", "WEBTPAAetnaNonemployee_Outpatient": "13714.4568", "WEBTPAAetnaNonemployee_EmergencyRoom": "13714.4568", "WELLCAREHEALTHPLANS_OPPS": "513.86" }, { "Description": "DEB BONE 20 SQ CM/<", "ProcedureCode": "11044", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "7210.93", "EmergencyRoomGrossCharge": "7210.93", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "3533.3557", "MinimumNegotiatedCharge": "1379.32", "MaximumNegotiatedCharge": "6345.6184", "AARPMedicareManagedCare_OPPS": "1379.32", "ADVANTRAFREEDOM_OPPS": "1379.32", "AETNA_Outpatient": "6345.6184", "AETNA_EmergencyRoom": "6345.6184", "AETNAMEDICAREADVANTAGE_OPPS": "1379.32", "AETNAOTHER_Outpatient": "6345.6184", "AETNAOTHER_EmergencyRoom": "6345.6184", "Allwell_OPPS": "1379.32", "Amerigroup_OPPS": "1379.32", "ARKANSASCOMMUNITYCARE_OPPS": "1379.32", "Cigna-Healthspring_OPPS": "1379.32", "GOLDENRULEINSCO_OPPS": "1379.32", "HUMANACHOICEPPO_OPPS": "1379.32", "HUMANAGOLD(MCRHMO)_OPPS": "1379.32", "HUMANAGOLDPFFS_OPPS": "1379.32", "MEDICARE_OPPS": "1379.32", "MedicareAdvantageOther_OPPS": "1379.32", "MedicareRailroad_OPPS": "1379.32", "MEDIPAK_OPPS": "1379.32", "MEDIPAKADVANTAGE_OPPS": "1379.32", "MVPHEALTHCARE_OPPS": "1379.32", "PYRAMID/MCRHMO_OPPS": "1379.32", "QUALCHOICE_Outpatient": "4038.1208", "QUALCHOICE_EmergencyRoom": "4038.1208", "SECUREHORIZONS_OPPS": "1379.32", "STERLINGOPTIONONE,STER_OPPS": "1379.32", "TributeHealthPlan_OPPS": "1379.32", "TRICAREEAST_OPPS": "1379.32", "TRICAREFORLIFE_OPPS": "1379.32", "TRICAREWEST_OPPS": "1379.32", "UMR_OPPS": "1379.32", "UNITEDHCOFRIVERVALLEY_OPPS": "1379.32", "UNITEDHEALTHCARE_OPPS": "1379.32", "UNITEDHEALTHCAREADVANTAGE_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+GA_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+UT_OPPS": "1379.32", "UNITEDHEALTHCAREOTHER_OPPS": "1379.32", "UnitedHealthcareSharedServ._OPPS": "1379.32", "VACHAMPVA_OPPS": "1379.32", "WEBTPAAetnaNonemployee_Outpatient": "6345.6184", "WEBTPAAetnaNonemployee_EmergencyRoom": "6345.6184", "WELLCAREHEALTHPLANS_OPPS": "1379.32" }, { "Description": "DEB SUBQ TISSUE ADD-ON", "ProcedureCode": "11045", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "3055.00", "EmergencyRoomGrossCharge": "3055.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "1496.9500", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "2688.4000", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "2688.4000", "AETNA_EmergencyRoom": "2688.4000", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "2688.4000", "AETNAOTHER_EmergencyRoom": "2688.4000", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "1710.8000", "QUALCHOICE_EmergencyRoom": "1710.8000", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "2688.4000", "WEBTPAAetnaNonemployee_EmergencyRoom": "2688.4000", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "DEB MUSC/FASCIA ADD-ON", "ProcedureCode": "11046", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "100.00", "EmergencyRoomGrossCharge": "100.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "49.0000", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "88.0000", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "88.0000", "AETNA_EmergencyRoom": "88.0000", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "88.0000", "AETNAOTHER_EmergencyRoom": "88.0000", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "56.0000", "QUALCHOICE_EmergencyRoom": "56.0000", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "88.0000", "WEBTPAAetnaNonemployee_EmergencyRoom": "88.0000", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "DEB BONE ADD-ON", "ProcedureCode": "11047", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "3337.00", "EmergencyRoomGrossCharge": "3337.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "1635.1300", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "2936.5600", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "2936.5600", "AETNA_EmergencyRoom": "2936.5600", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "2936.5600", "AETNAOTHER_EmergencyRoom": "2936.5600", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "1868.7200", "QUALCHOICE_EmergencyRoom": "1868.7200", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "2936.5600", "WEBTPAAetnaNonemployee_EmergencyRoom": "2936.5600", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "TRIM SKIN LESION", "ProcedureCode": "11055", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "428.00", "EmergencyRoomGrossCharge": "428.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "209.7200", "MinimumNegotiatedCharge": "176.02", "MaximumNegotiatedCharge": "376.6400", "AARPMedicareManagedCare_OPPS": "176.02", "ADVANTRAFREEDOM_OPPS": "176.02", "AETNA_Outpatient": "376.6400", "AETNA_EmergencyRoom": "376.6400", "AETNAMEDICAREADVANTAGE_OPPS": "176.02", "AETNAOTHER_Outpatient": "376.6400", "AETNAOTHER_EmergencyRoom": "376.6400", "Allwell_OPPS": "176.02", "Amerigroup_OPPS": "176.02", "ARKANSASCOMMUNITYCARE_OPPS": "176.02", "Cigna-Healthspring_OPPS": "176.02", "GOLDENRULEINSCO_OPPS": "176.02", "HUMANACHOICEPPO_OPPS": "176.02", "HUMANAGOLD(MCRHMO)_OPPS": "176.02", "HUMANAGOLDPFFS_OPPS": "176.02", "MEDICARE_OPPS": "176.02", "MedicareAdvantageOther_OPPS": "176.02", "MedicareRailroad_OPPS": "176.02", "MEDIPAK_OPPS": "176.02", "MEDIPAKADVANTAGE_OPPS": "176.02", "MVPHEALTHCARE_OPPS": "176.02", "PYRAMID/MCRHMO_OPPS": "176.02", "QUALCHOICE_Outpatient": "239.6800", "QUALCHOICE_EmergencyRoom": "239.6800", "SECUREHORIZONS_OPPS": "176.02", "STERLINGOPTIONONE,STER_OPPS": "176.02", "TributeHealthPlan_OPPS": "176.02", "TRICAREEAST_OPPS": "176.02", "TRICAREFORLIFE_OPPS": "176.02", "TRICAREWEST_OPPS": "176.02", "UMR_OPPS": "176.02", "UNITEDHCOFRIVERVALLEY_OPPS": "176.02", "UNITEDHEALTHCARE_OPPS": "176.02", "UNITEDHEALTHCAREADVANTAGE_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+GA_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+UT_OPPS": "176.02", "UNITEDHEALTHCAREOTHER_OPPS": "176.02", "UnitedHealthcareSharedServ._OPPS": "176.02", "VACHAMPVA_OPPS": "176.02", "WEBTPAAetnaNonemployee_Outpatient": "376.6400", "WEBTPAAetnaNonemployee_EmergencyRoom": "376.6400", "WELLCAREHEALTHPLANS_OPPS": "176.02" }, { "Description": "TRIM SKIN LESIONS 2 TO 4", "ProcedureCode": "11056", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "428.00", "EmergencyRoomGrossCharge": "428.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "209.7200", "MinimumNegotiatedCharge": "176.02", "MaximumNegotiatedCharge": "376.6400", "AARPMedicareManagedCare_OPPS": "176.02", "ADVANTRAFREEDOM_OPPS": "176.02", "AETNA_Outpatient": "376.6400", "AETNA_EmergencyRoom": "376.6400", "AETNAMEDICAREADVANTAGE_OPPS": "176.02", "AETNAOTHER_Outpatient": "376.6400", "AETNAOTHER_EmergencyRoom": "376.6400", "Allwell_OPPS": "176.02", "Amerigroup_OPPS": "176.02", "ARKANSASCOMMUNITYCARE_OPPS": "176.02", "Cigna-Healthspring_OPPS": "176.02", "GOLDENRULEINSCO_OPPS": "176.02", "HUMANACHOICEPPO_OPPS": "176.02", "HUMANAGOLD(MCRHMO)_OPPS": "176.02", "HUMANAGOLDPFFS_OPPS": "176.02", "MEDICARE_OPPS": "176.02", "MedicareAdvantageOther_OPPS": "176.02", "MedicareRailroad_OPPS": "176.02", "MEDIPAK_OPPS": "176.02", "MEDIPAKADVANTAGE_OPPS": "176.02", "MVPHEALTHCARE_OPPS": "176.02", "PYRAMID/MCRHMO_OPPS": "176.02", "QUALCHOICE_Outpatient": "239.6800", "QUALCHOICE_EmergencyRoom": "239.6800", "SECUREHORIZONS_OPPS": "176.02", "STERLINGOPTIONONE,STER_OPPS": "176.02", "TributeHealthPlan_OPPS": "176.02", "TRICAREEAST_OPPS": "176.02", "TRICAREFORLIFE_OPPS": "176.02", "TRICAREWEST_OPPS": "176.02", "UMR_OPPS": "176.02", "UNITEDHCOFRIVERVALLEY_OPPS": "176.02", "UNITEDHEALTHCARE_OPPS": "176.02", "UNITEDHEALTHCAREADVANTAGE_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+GA_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+UT_OPPS": "176.02", "UNITEDHEALTHCAREOTHER_OPPS": "176.02", "UnitedHealthcareSharedServ._OPPS": "176.02", "VACHAMPVA_OPPS": "176.02", "WEBTPAAetnaNonemployee_Outpatient": "376.6400", "WEBTPAAetnaNonemployee_EmergencyRoom": "376.6400", "WELLCAREHEALTHPLANS_OPPS": "176.02" }, { "Description": "TRIM SKIN LESIONS OVER 4", "ProcedureCode": "11057", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "428.00", "EmergencyRoomGrossCharge": "428.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "209.7200", "MinimumNegotiatedCharge": "176.02", "MaximumNegotiatedCharge": "376.6400", "AARPMedicareManagedCare_OPPS": "176.02", "ADVANTRAFREEDOM_OPPS": "176.02", "AETNA_Outpatient": "376.6400", "AETNA_EmergencyRoom": "376.6400", "AETNAMEDICAREADVANTAGE_OPPS": "176.02", "AETNAOTHER_Outpatient": "376.6400", "AETNAOTHER_EmergencyRoom": "376.6400", "Allwell_OPPS": "176.02", "Amerigroup_OPPS": "176.02", "ARKANSASCOMMUNITYCARE_OPPS": "176.02", "Cigna-Healthspring_OPPS": "176.02", "GOLDENRULEINSCO_OPPS": "176.02", "HUMANACHOICEPPO_OPPS": "176.02", "HUMANAGOLD(MCRHMO)_OPPS": "176.02", "HUMANAGOLDPFFS_OPPS": "176.02", "MEDICARE_OPPS": "176.02", "MedicareAdvantageOther_OPPS": "176.02", "MedicareRailroad_OPPS": "176.02", "MEDIPAK_OPPS": "176.02", "MEDIPAKADVANTAGE_OPPS": "176.02", "MVPHEALTHCARE_OPPS": "176.02", "PYRAMID/MCRHMO_OPPS": "176.02", "QUALCHOICE_Outpatient": "239.6800", "QUALCHOICE_EmergencyRoom": "239.6800", "SECUREHORIZONS_OPPS": "176.02", "STERLINGOPTIONONE,STER_OPPS": "176.02", "TributeHealthPlan_OPPS": "176.02", "TRICAREEAST_OPPS": "176.02", "TRICAREFORLIFE_OPPS": "176.02", "TRICAREWEST_OPPS": "176.02", "UMR_OPPS": "176.02", "UNITEDHCOFRIVERVALLEY_OPPS": "176.02", "UNITEDHEALTHCARE_OPPS": "176.02", "UNITEDHEALTHCAREADVANTAGE_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+GA_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+UT_OPPS": "176.02", "UNITEDHEALTHCAREOTHER_OPPS": "176.02", "UnitedHealthcareSharedServ._OPPS": "176.02", "VACHAMPVA_OPPS": "176.02", "WEBTPAAetnaNonemployee_Outpatient": "376.6400", "WEBTPAAetnaNonemployee_EmergencyRoom": "376.6400", "WELLCAREHEALTHPLANS_OPPS": "176.02" }, { "Description": "TANGNTL BX SKIN SINGLE LES", "ProcedureCode": "11102", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "328.00", "EmergencyRoomGrossCharge": "328.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "160.7200", "MinimumNegotiatedCharge": "176.02", "MaximumNegotiatedCharge": "288.6400", "AARPMedicareManagedCare_OPPS": "176.02", "ADVANTRAFREEDOM_OPPS": "176.02", "AETNA_Outpatient": "288.6400", "AETNA_EmergencyRoom": "288.6400", "AETNAMEDICAREADVANTAGE_OPPS": "176.02", "AETNAOTHER_Outpatient": "288.6400", "AETNAOTHER_EmergencyRoom": "288.6400", "Allwell_OPPS": "176.02", "Amerigroup_OPPS": "176.02", "ARKANSASCOMMUNITYCARE_OPPS": "176.02", "Cigna-Healthspring_OPPS": "176.02", "GOLDENRULEINSCO_OPPS": "176.02", "HUMANACHOICEPPO_OPPS": "176.02", "HUMANAGOLD(MCRHMO)_OPPS": "176.02", "HUMANAGOLDPFFS_OPPS": "176.02", "MEDICARE_OPPS": "176.02", "MedicareAdvantageOther_OPPS": "176.02", "MedicareRailroad_OPPS": "176.02", "MEDIPAK_OPPS": "176.02", "MEDIPAKADVANTAGE_OPPS": "176.02", "MVPHEALTHCARE_OPPS": "176.02", "PYRAMID/MCRHMO_OPPS": "176.02", "QUALCHOICE_Outpatient": "183.6800", "QUALCHOICE_EmergencyRoom": "183.6800", "SECUREHORIZONS_OPPS": "176.02", "STERLINGOPTIONONE,STER_OPPS": "176.02", "TributeHealthPlan_OPPS": "176.02", "TRICAREEAST_OPPS": "176.02", "TRICAREFORLIFE_OPPS": "176.02", "TRICAREWEST_OPPS": "176.02", "UMR_OPPS": "176.02", "UNITEDHCOFRIVERVALLEY_OPPS": "176.02", "UNITEDHEALTHCARE_OPPS": "176.02", "UNITEDHEALTHCAREADVANTAGE_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+GA_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+UT_OPPS": "176.02", "UNITEDHEALTHCAREOTHER_OPPS": "176.02", "UnitedHealthcareSharedServ._OPPS": "176.02", "VACHAMPVA_OPPS": "176.02", "WEBTPAAetnaNonemployee_Outpatient": "288.6400", "WEBTPAAetnaNonemployee_EmergencyRoom": "288.6400", "WELLCAREHEALTHPLANS_OPPS": "176.02" }, { "Description": "TANGNTL BX SKIN EA SEP/ADDL", "ProcedureCode": "11103", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "318.00", "EmergencyRoomGrossCharge": "318.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "155.8200", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "279.8400", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "279.8400", "AETNA_EmergencyRoom": "279.8400", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "279.8400", "AETNAOTHER_EmergencyRoom": "279.8400", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "178.0800", "QUALCHOICE_EmergencyRoom": "178.0800", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "279.8400", "WEBTPAAetnaNonemployee_EmergencyRoom": "279.8400", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "PUNCH BX SKIN SINGLE LESION", "ProcedureCode": "11104", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "735.00", "EmergencyRoomGrossCharge": "735.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "360.1500", "MinimumNegotiatedCharge": "339.04", "MaximumNegotiatedCharge": "646.8000", "AARPMedicareManagedCare_OPPS": "339.04", "ADVANTRAFREEDOM_OPPS": "339.04", "AETNA_Outpatient": "646.8000", "AETNA_EmergencyRoom": "646.8000", "AETNAMEDICAREADVANTAGE_OPPS": "339.04", "AETNAOTHER_Outpatient": "646.8000", "AETNAOTHER_EmergencyRoom": "646.8000", "Allwell_OPPS": "339.04", "Amerigroup_OPPS": "339.04", "ARKANSASCOMMUNITYCARE_OPPS": "339.04", "Cigna-Healthspring_OPPS": "339.04", "GOLDENRULEINSCO_OPPS": "339.04", "HUMANACHOICEPPO_OPPS": "339.04", "HUMANAGOLD(MCRHMO)_OPPS": "339.04", "HUMANAGOLDPFFS_OPPS": "339.04", "MEDICARE_OPPS": "339.04", "MedicareAdvantageOther_OPPS": "339.04", "MedicareRailroad_OPPS": "339.04", "MEDIPAK_OPPS": "339.04", "MEDIPAKADVANTAGE_OPPS": "339.04", "MVPHEALTHCARE_OPPS": "339.04", "PYRAMID/MCRHMO_OPPS": "339.04", "QUALCHOICE_Outpatient": "411.6000", "QUALCHOICE_EmergencyRoom": "411.6000", "SECUREHORIZONS_OPPS": "339.04", "STERLINGOPTIONONE,STER_OPPS": "339.04", "TributeHealthPlan_OPPS": "339.04", "TRICAREEAST_OPPS": "339.04", "TRICAREFORLIFE_OPPS": "339.04", "TRICAREWEST_OPPS": "339.04", "UMR_OPPS": "339.04", "UNITEDHCOFRIVERVALLEY_OPPS": "339.04", "UNITEDHEALTHCARE_OPPS": "339.04", "UNITEDHEALTHCAREADVANTAGE_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+GA_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+UT_OPPS": "339.04", "UNITEDHEALTHCAREOTHER_OPPS": "339.04", "UnitedHealthcareSharedServ._OPPS": "339.04", "VACHAMPVA_OPPS": "339.04", "WEBTPAAetnaNonemployee_Outpatient": "646.8000", "WEBTPAAetnaNonemployee_EmergencyRoom": "646.8000", "WELLCAREHEALTHPLANS_OPPS": "339.04" }, { "Description": "PUNCH BX SKIN EA SEP/ADDL", "ProcedureCode": "11105", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "428.00", "EmergencyRoomGrossCharge": "428.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "209.7200", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "376.6400", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "376.6400", "AETNA_EmergencyRoom": "376.6400", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "376.6400", "AETNAOTHER_EmergencyRoom": "376.6400", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "239.6800", "QUALCHOICE_EmergencyRoom": "239.6800", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "376.6400", "WEBTPAAetnaNonemployee_EmergencyRoom": "376.6400", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "INCAL BX SKN SINGLE LES", "ProcedureCode": "11106", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "762.00", "EmergencyRoomGrossCharge": "762.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "373.3800", "MinimumNegotiatedCharge": "426.7200", "MaximumNegotiatedCharge": "670.5600", "AARPMedicareManagedCare_OPPS": "513.86", "ADVANTRAFREEDOM_OPPS": "513.86", "AETNA_Outpatient": "670.5600", "AETNA_EmergencyRoom": "670.5600", "AETNAMEDICAREADVANTAGE_OPPS": "513.86", "AETNAOTHER_Outpatient": "670.5600", "AETNAOTHER_EmergencyRoom": "670.5600", "Allwell_OPPS": "513.86", "Amerigroup_OPPS": "513.86", "ARKANSASCOMMUNITYCARE_OPPS": "513.86", "Cigna-Healthspring_OPPS": "513.86", "GOLDENRULEINSCO_OPPS": "513.86", "HUMANACHOICEPPO_OPPS": "513.86", "HUMANAGOLD(MCRHMO)_OPPS": "513.86", "HUMANAGOLDPFFS_OPPS": "513.86", "MEDICARE_OPPS": "513.86", "MedicareAdvantageOther_OPPS": "513.86", "MedicareRailroad_OPPS": "513.86", "MEDIPAK_OPPS": "513.86", "MEDIPAKADVANTAGE_OPPS": "513.86", "MVPHEALTHCARE_OPPS": "513.86", "PYRAMID/MCRHMO_OPPS": "513.86", "QUALCHOICE_Outpatient": "426.7200", "QUALCHOICE_EmergencyRoom": "426.7200", "SECUREHORIZONS_OPPS": "513.86", "STERLINGOPTIONONE,STER_OPPS": "513.86", "TributeHealthPlan_OPPS": "513.86", "TRICAREEAST_OPPS": "513.86", "TRICAREFORLIFE_OPPS": "513.86", "TRICAREWEST_OPPS": "513.86", "UMR_OPPS": "513.86", "UNITEDHCOFRIVERVALLEY_OPPS": "513.86", "UNITEDHEALTHCARE_OPPS": "513.86", "UNITEDHEALTHCAREADVANTAGE_OPPS": "513.86", "UNITEDHEALTHCARECHOICE+GA_OPPS": "513.86", "UNITEDHEALTHCARECHOICE+UT_OPPS": "513.86", "UNITEDHEALTHCAREOTHER_OPPS": "513.86", "UnitedHealthcareSharedServ._OPPS": "513.86", "VACHAMPVA_OPPS": "513.86", "WEBTPAAetnaNonemployee_Outpatient": "670.5600", "WEBTPAAetnaNonemployee_EmergencyRoom": "670.5600", "WELLCAREHEALTHPLANS_OPPS": "513.86" }, { "Description": "INCAL BX SKN EA SEP/ADDL", "ProcedureCode": "11107", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "762.00", "EmergencyRoomGrossCharge": "762.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "373.3800", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "670.5600", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "670.5600", "AETNA_EmergencyRoom": "670.5600", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "670.5600", "AETNAOTHER_EmergencyRoom": "670.5600", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "426.7200", "QUALCHOICE_EmergencyRoom": "426.7200", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "670.5600", "WEBTPAAetnaNonemployee_EmergencyRoom": "670.5600", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "REMOVAL OF SKIN TAGS 4.0 CM", "ProcedureCode": "11406", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "7326.42", "EmergencyRoomGrossCharge": "7326.42", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "3589.9458", "MinimumNegotiatedCharge": "1379.32", "MaximumNegotiatedCharge": "6447.2496", "AARPMedicareManagedCare_OPPS": "1379.32", "ADVANTRAFREEDOM_OPPS": "1379.32", "AETNA_Outpatient": "6447.2496", "AETNA_EmergencyRoom": "6447.2496", "AETNAMEDICAREADVANTAGE_OPPS": "1379.32", "AETNAOTHER_Outpatient": "6447.2496", "AETNAOTHER_EmergencyRoom": "6447.2496", "Allwell_OPPS": "1379.32", "Amerigroup_OPPS": "1379.32", "ARKANSASCOMMUNITYCARE_OPPS": "1379.32", "Cigna-Healthspring_OPPS": "1379.32", "GOLDENRULEINSCO_OPPS": "1379.32", "HUMANACHOICEPPO_OPPS": "1379.32", "HUMANAGOLD(MCRHMO)_OPPS": "1379.32", "HUMANAGOLDPFFS_OPPS": "1379.32", "MEDICARE_OPPS": "1379.32", "MedicareAdvantageOther_OPPS": "1379.32", "MedicareRailroad_OPPS": "1379.32", "MEDIPAK_OPPS": "1379.32", "MEDIPAKADVANTAGE_OPPS": "1379.32", "MVPHEALTHCARE_OPPS": "1379.32", "PYRAMID/MCRHMO_OPPS": "1379.32", "QUALCHOICE_Outpatient": "4102.7952", "QUALCHOICE_EmergencyRoom": "4102.7952", "SECUREHORIZONS_OPPS": "1379.32", "STERLINGOPTIONONE,STER_OPPS": "1379.32", "TributeHealthPlan_OPPS": "1379.32", "TRICAREEAST_OPPS": "1379.32", "TRICAREFORLIFE_OPPS": "1379.32", "TRICAREWEST_OPPS": "1379.32", "UMR_OPPS": "1379.32", "UNITEDHCOFRIVERVALLEY_OPPS": "1379.32", "UNITEDHEALTHCARE_OPPS": "1379.32", "UNITEDHEALTHCAREADVANTAGE_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+GA_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+UT_OPPS": "1379.32", "UNITEDHEALTHCAREOTHER_OPPS": "1379.32", "UnitedHealthcareSharedServ._OPPS": "1379.32", "VACHAMPVA_OPPS": "1379.32", "WEBTPAAetnaNonemployee_Outpatient": "6447.2496", "WEBTPAAetnaNonemployee_EmergencyRoom": "6447.2496", "WELLCAREHEALTHPLANS_OPPS": "1379.32" }, { "Description": "EXC H-F-NK-SP B9+MARG 0.5/<", "ProcedureCode": "11420", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "3092.00", "EmergencyRoomGrossCharge": "3092.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "1515.0800", "MinimumNegotiatedCharge": "1379.32", "MaximumNegotiatedCharge": "2720.9600", "AARPMedicareManagedCare_OPPS": "1379.32", "ADVANTRAFREEDOM_OPPS": "1379.32", "AETNA_Outpatient": "2720.9600", "AETNA_EmergencyRoom": "2720.9600", "AETNAMEDICAREADVANTAGE_OPPS": "1379.32", "AETNAOTHER_Outpatient": "2720.9600", "AETNAOTHER_EmergencyRoom": "2720.9600", "Allwell_OPPS": "1379.32", "Amerigroup_OPPS": "1379.32", "ARKANSASCOMMUNITYCARE_OPPS": "1379.32", "Cigna-Healthspring_OPPS": "1379.32", "GOLDENRULEINSCO_OPPS": "1379.32", "HUMANACHOICEPPO_OPPS": "1379.32", "HUMANAGOLD(MCRHMO)_OPPS": "1379.32", "HUMANAGOLDPFFS_OPPS": "1379.32", "MEDICARE_OPPS": "1379.32", "MedicareAdvantageOther_OPPS": "1379.32", "MedicareRailroad_OPPS": "1379.32", "MEDIPAK_OPPS": "1379.32", "MEDIPAKADVANTAGE_OPPS": "1379.32", "MVPHEALTHCARE_OPPS": "1379.32", "PYRAMID/MCRHMO_OPPS": "1379.32", "QUALCHOICE_Outpatient": "1731.5200", "QUALCHOICE_EmergencyRoom": "1731.5200", "SECUREHORIZONS_OPPS": "1379.32", "STERLINGOPTIONONE,STER_OPPS": "1379.32", "TributeHealthPlan_OPPS": "1379.32", "TRICAREEAST_OPPS": "1379.32", "TRICAREFORLIFE_OPPS": "1379.32", "TRICAREWEST_OPPS": "1379.32", "UMR_OPPS": "1379.32", "UNITEDHCOFRIVERVALLEY_OPPS": "1379.32", "UNITEDHEALTHCARE_OPPS": "1379.32", "UNITEDHEALTHCAREADVANTAGE_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+GA_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+UT_OPPS": "1379.32", "UNITEDHEALTHCAREOTHER_OPPS": "1379.32", "UnitedHealthcareSharedServ._OPPS": "1379.32", "VACHAMPVA_OPPS": "1379.32", "WEBTPAAetnaNonemployee_Outpatient": "2720.9600", "WEBTPAAetnaNonemployee_EmergencyRoom": "2720.9600", "WELLCAREHEALTHPLANS_OPPS": "1379.32" }, { "Description": "EXC H-F-NK-SP B9+MARG 0.6-1", "ProcedureCode": "11421", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "7638.11", "EmergencyRoomGrossCharge": "7638.11", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "3742.6739", "MinimumNegotiatedCharge": "609.74", "MaximumNegotiatedCharge": "6721.5368", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "6721.5368", "AETNA_EmergencyRoom": "6721.5368", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "6721.5368", "AETNAOTHER_EmergencyRoom": "6721.5368", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "4277.3416", "QUALCHOICE_EmergencyRoom": "4277.3416", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "6721.5368", "WEBTPAAetnaNonemployee_EmergencyRoom": "6721.5368", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "EXC H-F-NK-SP B9+MARG 1.1-2", "ProcedureCode": "11422", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "7291.86", "EmergencyRoomGrossCharge": "7291.86", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "3573.0114", "MinimumNegotiatedCharge": "1379.32", "MaximumNegotiatedCharge": "6416.8368", "AARPMedicareManagedCare_OPPS": "1379.32", "ADVANTRAFREEDOM_OPPS": "1379.32", "AETNA_Outpatient": "6416.8368", "AETNA_EmergencyRoom": "6416.8368", "AETNAMEDICAREADVANTAGE_OPPS": "1379.32", "AETNAOTHER_Outpatient": "6416.8368", "AETNAOTHER_EmergencyRoom": "6416.8368", "Allwell_OPPS": "1379.32", "Amerigroup_OPPS": "1379.32", "ARKANSASCOMMUNITYCARE_OPPS": "1379.32", "Cigna-Healthspring_OPPS": "1379.32", "GOLDENRULEINSCO_OPPS": "1379.32", "HUMANACHOICEPPO_OPPS": "1379.32", "HUMANAGOLD(MCRHMO)_OPPS": "1379.32", "HUMANAGOLDPFFS_OPPS": "1379.32", "MEDICARE_OPPS": "1379.32", "MedicareAdvantageOther_OPPS": "1379.32", "MedicareRailroad_OPPS": "1379.32", "MEDIPAK_OPPS": "1379.32", "MEDIPAKADVANTAGE_OPPS": "1379.32", "MVPHEALTHCARE_OPPS": "1379.32", "PYRAMID/MCRHMO_OPPS": "1379.32", "QUALCHOICE_Outpatient": "4083.4416", "QUALCHOICE_EmergencyRoom": "4083.4416", "SECUREHORIZONS_OPPS": "1379.32", "STERLINGOPTIONONE,STER_OPPS": "1379.32", "TributeHealthPlan_OPPS": "1379.32", "TRICAREEAST_OPPS": "1379.32", "TRICAREFORLIFE_OPPS": "1379.32", "TRICAREWEST_OPPS": "1379.32", "UMR_OPPS": "1379.32", "UNITEDHCOFRIVERVALLEY_OPPS": "1379.32", "UNITEDHEALTHCARE_OPPS": "1379.32", "UNITEDHEALTHCAREADVANTAGE_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+GA_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+UT_OPPS": "1379.32", "UNITEDHEALTHCAREOTHER_OPPS": "1379.32", "UnitedHealthcareSharedServ._OPPS": "1379.32", "VACHAMPVA_OPPS": "1379.32", "WEBTPAAetnaNonemployee_Outpatient": "6416.8368", "WEBTPAAetnaNonemployee_EmergencyRoom": "6416.8368", "WELLCAREHEALTHPLANS_OPPS": "1379.32" }, { "Description": "EXC FACE-MM B9+MARG 1.1-2 C", "ProcedureCode": "11442", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1045.00", "EmergencyRoomGrossCharge": "1045.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "512.0500", "MinimumNegotiatedCharge": "585.2000", "MaximumNegotiatedCharge": "919.6000", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "919.6000", "AETNA_EmergencyRoom": "919.6000", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "919.6000", "AETNAOTHER_EmergencyRoom": "919.6000", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "585.2000", "QUALCHOICE_EmergencyRoom": "585.2000", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "919.6000", "WEBTPAAetnaNonemployee_EmergencyRoom": "919.6000", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "REMOVAL SWEAT GLAND LESION", "ProcedureCode": "11462", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "8209.18", "EmergencyRoomGrossCharge": "8209.18", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "4022.4982", "MinimumNegotiatedCharge": "2323.39", "MaximumNegotiatedCharge": "7224.0784", "AARPMedicareManagedCare_OPPS": "2323.39", "ADVANTRAFREEDOM_OPPS": "2323.39", "AETNA_Outpatient": "7224.0784", "AETNA_EmergencyRoom": "7224.0784", "AETNAMEDICAREADVANTAGE_OPPS": "2323.39", "AETNAOTHER_Outpatient": "7224.0784", "AETNAOTHER_EmergencyRoom": "7224.0784", "Allwell_OPPS": "2323.39", "Amerigroup_OPPS": "2323.39", "ARKANSASCOMMUNITYCARE_OPPS": "2323.39", "Cigna-Healthspring_OPPS": "2323.39", "GOLDENRULEINSCO_OPPS": "2323.39", "HUMANACHOICEPPO_OPPS": "2323.39", "HUMANAGOLD(MCRHMO)_OPPS": "2323.39", "HUMANAGOLDPFFS_OPPS": "2323.39", "MEDICARE_OPPS": "2323.39", "MedicareAdvantageOther_OPPS": "2323.39", "MedicareRailroad_OPPS": "2323.39", "MEDIPAK_OPPS": "2323.39", "MEDIPAKADVANTAGE_OPPS": "2323.39", "MVPHEALTHCARE_OPPS": "2323.39", "PYRAMID/MCRHMO_OPPS": "2323.39", "QUALCHOICE_Outpatient": "4597.1408", "QUALCHOICE_EmergencyRoom": "4597.1408", "SECUREHORIZONS_OPPS": "2323.39", "STERLINGOPTIONONE,STER_OPPS": "2323.39", "TributeHealthPlan_OPPS": "2323.39", "TRICAREEAST_OPPS": "2323.39", "TRICAREFORLIFE_OPPS": "2323.39", "TRICAREWEST_OPPS": "2323.39", "UMR_OPPS": "2323.39", "UNITEDHCOFRIVERVALLEY_OPPS": "2323.39", "UNITEDHEALTHCARE_OPPS": "2323.39", "UNITEDHEALTHCAREADVANTAGE_OPPS": "2323.39", "UNITEDHEALTHCARECHOICE+GA_OPPS": "2323.39", "UNITEDHEALTHCARECHOICE+UT_OPPS": "2323.39", "UNITEDHEALTHCAREOTHER_OPPS": "2323.39", "UnitedHealthcareSharedServ._OPPS": "2323.39", "VACHAMPVA_OPPS": "2323.39", "WEBTPAAetnaNonemployee_Outpatient": "7224.0784", "WEBTPAAetnaNonemployee_EmergencyRoom": "7224.0784", "WELLCAREHEALTHPLANS_OPPS": "2323.39" }, { "Description": "EXC TR-EXT MAL+MARG 1.1-2 C", "ProcedureCode": "11602", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "6988.55", "EmergencyRoomGrossCharge": "6988.55", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "3424.3895", "MinimumNegotiatedCharge": "339.04", "MaximumNegotiatedCharge": "6149.9240", "AARPMedicareManagedCare_OPPS": "339.04", "ADVANTRAFREEDOM_OPPS": "339.04", "AETNA_Outpatient": "6149.9240", "AETNA_EmergencyRoom": "6149.9240", "AETNAMEDICAREADVANTAGE_OPPS": "339.04", "AETNAOTHER_Outpatient": "6149.9240", "AETNAOTHER_EmergencyRoom": "6149.9240", "Allwell_OPPS": "339.04", "Amerigroup_OPPS": "339.04", "ARKANSASCOMMUNITYCARE_OPPS": "339.04", "Cigna-Healthspring_OPPS": "339.04", "GOLDENRULEINSCO_OPPS": "339.04", "HUMANACHOICEPPO_OPPS": "339.04", "HUMANAGOLD(MCRHMO)_OPPS": "339.04", "HUMANAGOLDPFFS_OPPS": "339.04", "MEDICARE_OPPS": "339.04", "MedicareAdvantageOther_OPPS": "339.04", "MedicareRailroad_OPPS": "339.04", "MEDIPAK_OPPS": "339.04", "MEDIPAKADVANTAGE_OPPS": "339.04", "MVPHEALTHCARE_OPPS": "339.04", "PYRAMID/MCRHMO_OPPS": "339.04", "QUALCHOICE_Outpatient": "3913.5880", "QUALCHOICE_EmergencyRoom": "3913.5880", "SECUREHORIZONS_OPPS": "339.04", "STERLINGOPTIONONE,STER_OPPS": "339.04", "TributeHealthPlan_OPPS": "339.04", "TRICAREEAST_OPPS": "339.04", "TRICAREFORLIFE_OPPS": "339.04", "TRICAREWEST_OPPS": "339.04", "UMR_OPPS": "339.04", "UNITEDHCOFRIVERVALLEY_OPPS": "339.04", "UNITEDHEALTHCARE_OPPS": "339.04", "UNITEDHEALTHCAREADVANTAGE_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+GA_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+UT_OPPS": "339.04", "UNITEDHEALTHCAREOTHER_OPPS": "339.04", "UnitedHealthcareSharedServ._OPPS": "339.04", "VACHAMPVA_OPPS": "339.04", "WEBTPAAetnaNonemployee_Outpatient": "6149.9240", "WEBTPAAetnaNonemployee_EmergencyRoom": "6149.9240", "WELLCAREHEALTHPLANS_OPPS": "339.04" }, { "Description": "EXC S/N/H/F/G MAL+MRG 0.6-1", "ProcedureCode": "11621", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1347.78", "EmergencyRoomGrossCharge": "1347.78", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "660.4122", "MinimumNegotiatedCharge": "609.74", "MaximumNegotiatedCharge": "1186.0464", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "1186.0464", "AETNA_EmergencyRoom": "1186.0464", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "1186.0464", "AETNAOTHER_EmergencyRoom": "1186.0464", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "754.7568", "QUALCHOICE_EmergencyRoom": "754.7568", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "1186.0464", "WEBTPAAetnaNonemployee_EmergencyRoom": "1186.0464", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "EXC S/N/H/F/G MAL+MRG 1.1-2", "ProcedureCode": "11622", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "8748.71", "EmergencyRoomGrossCharge": "8748.71", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "4286.8679", "MinimumNegotiatedCharge": "609.74", "MaximumNegotiatedCharge": "7698.8648", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "7698.8648", "AETNA_EmergencyRoom": "7698.8648", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "7698.8648", "AETNAOTHER_EmergencyRoom": "7698.8648", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "4899.2776", "QUALCHOICE_EmergencyRoom": "4899.2776", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "7698.8648", "WEBTPAAetnaNonemployee_EmergencyRoom": "7698.8648", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "EXC S/N/H/F/G MAL+MRG 2.1-3", "ProcedureCode": "11623", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "3091.55", "EmergencyRoomGrossCharge": "3091.55", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "1514.8595", "MinimumNegotiatedCharge": "1379.32", "MaximumNegotiatedCharge": "2720.5640", "AARPMedicareManagedCare_OPPS": "1379.32", "ADVANTRAFREEDOM_OPPS": "1379.32", "AETNA_Outpatient": "2720.5640", "AETNA_EmergencyRoom": "2720.5640", "AETNAMEDICAREADVANTAGE_OPPS": "1379.32", "AETNAOTHER_Outpatient": "2720.5640", "AETNAOTHER_EmergencyRoom": "2720.5640", "Allwell_OPPS": "1379.32", "Amerigroup_OPPS": "1379.32", "ARKANSASCOMMUNITYCARE_OPPS": "1379.32", "Cigna-Healthspring_OPPS": "1379.32", "GOLDENRULEINSCO_OPPS": "1379.32", "HUMANACHOICEPPO_OPPS": "1379.32", "HUMANAGOLD(MCRHMO)_OPPS": "1379.32", "HUMANAGOLDPFFS_OPPS": "1379.32", "MEDICARE_OPPS": "1379.32", "MedicareAdvantageOther_OPPS": "1379.32", "MedicareRailroad_OPPS": "1379.32", "MEDIPAK_OPPS": "1379.32", "MEDIPAKADVANTAGE_OPPS": "1379.32", "MVPHEALTHCARE_OPPS": "1379.32", "PYRAMID/MCRHMO_OPPS": "1379.32", "QUALCHOICE_Outpatient": "1731.2680", "QUALCHOICE_EmergencyRoom": "1731.2680", "SECUREHORIZONS_OPPS": "1379.32", "STERLINGOPTIONONE,STER_OPPS": "1379.32", "TributeHealthPlan_OPPS": "1379.32", "TRICAREEAST_OPPS": "1379.32", "TRICAREFORLIFE_OPPS": "1379.32", "TRICAREWEST_OPPS": "1379.32", "UMR_OPPS": "1379.32", "UNITEDHCOFRIVERVALLEY_OPPS": "1379.32", "UNITEDHEALTHCARE_OPPS": "1379.32", "UNITEDHEALTHCAREADVANTAGE_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+GA_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+UT_OPPS": "1379.32", "UNITEDHEALTHCAREOTHER_OPPS": "1379.32", "UnitedHealthcareSharedServ._OPPS": "1379.32", "VACHAMPVA_OPPS": "1379.32", "WEBTPAAetnaNonemployee_Outpatient": "2720.5640", "WEBTPAAetnaNonemployee_EmergencyRoom": "2720.5640", "WELLCAREHEALTHPLANS_OPPS": "1379.32" }, { "Description": "EXC F/E/E/N/L MAL+MRG 0.6-1", "ProcedureCode": "11641", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "382.75", "EmergencyRoomGrossCharge": "382.75", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "187.5475", "MinimumNegotiatedCharge": "214.3400", "MaximumNegotiatedCharge": "609.74", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "336.8200", "AETNA_EmergencyRoom": "336.8200", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "336.8200", "AETNAOTHER_EmergencyRoom": "336.8200", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "214.3400", "QUALCHOICE_EmergencyRoom": "214.3400", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "336.8200", "WEBTPAAetnaNonemployee_EmergencyRoom": "336.8200", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "TRIM NAIL(S) ANY NUMBER", "ProcedureCode": "11719", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "136.00", "EmergencyRoomGrossCharge": "136.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "66.6400", "MinimumNegotiatedCharge": "54.57", "MaximumNegotiatedCharge": "119.6800", "AARPMedicareManagedCare_OPPS": "54.57", "ADVANTRAFREEDOM_OPPS": "54.57", "AETNA_Outpatient": "119.6800", "AETNA_EmergencyRoom": "119.6800", "AETNAMEDICAREADVANTAGE_OPPS": "54.57", "AETNAOTHER_Outpatient": "119.6800", "AETNAOTHER_EmergencyRoom": "119.6800", "Allwell_OPPS": "54.57", "Amerigroup_OPPS": "54.57", "ARKANSASCOMMUNITYCARE_OPPS": "54.57", "Cigna-Healthspring_OPPS": "54.57", "GOLDENRULEINSCO_OPPS": "54.57", "HUMANACHOICEPPO_OPPS": "54.57", "HUMANAGOLD(MCRHMO)_OPPS": "54.57", "HUMANAGOLDPFFS_OPPS": "54.57", "MEDICARE_OPPS": "54.57", "MedicareAdvantageOther_OPPS": "54.57", "MedicareRailroad_OPPS": "54.57", "MEDIPAK_OPPS": "54.57", "MEDIPAKADVANTAGE_OPPS": "54.57", "MVPHEALTHCARE_OPPS": "54.57", "PYRAMID/MCRHMO_OPPS": "54.57", "QUALCHOICE_Outpatient": "76.1600", "QUALCHOICE_EmergencyRoom": "76.1600", "SECUREHORIZONS_OPPS": "54.57", "STERLINGOPTIONONE,STER_OPPS": "54.57", "TributeHealthPlan_OPPS": "54.57", "TRICAREEAST_OPPS": "54.57", "TRICAREFORLIFE_OPPS": "54.57", "TRICAREWEST_OPPS": "54.57", "UMR_OPPS": "54.57", "UNITEDHCOFRIVERVALLEY_OPPS": "54.57", "UNITEDHEALTHCARE_OPPS": "54.57", "UNITEDHEALTHCAREADVANTAGE_OPPS": "54.57", "UNITEDHEALTHCARECHOICE+GA_OPPS": "54.57", "UNITEDHEALTHCARECHOICE+UT_OPPS": "54.57", "UNITEDHEALTHCAREOTHER_OPPS": "54.57", "UnitedHealthcareSharedServ._OPPS": "54.57", "VACHAMPVA_OPPS": "54.57", "WEBTPAAetnaNonemployee_Outpatient": "119.6800", "WEBTPAAetnaNonemployee_EmergencyRoom": "119.6800", "WELLCAREHEALTHPLANS_OPPS": "54.57" }, { "Description": "DEBRIDE NAIL 6 OR MORE", "ProcedureCode": "11721", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "65.00", "EmergencyRoomGrossCharge": "65.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "31.8500", "MinimumNegotiatedCharge": "36.4000", "MaximumNegotiatedCharge": "57.2000", "AARPMedicareManagedCare_OPPS": "54.57", "ADVANTRAFREEDOM_OPPS": "54.57", "AETNA_Outpatient": "57.2000", "AETNA_EmergencyRoom": "57.2000", "AETNAMEDICAREADVANTAGE_OPPS": "54.57", "AETNAOTHER_Outpatient": "57.2000", "AETNAOTHER_EmergencyRoom": "57.2000", "Allwell_OPPS": "54.57", "Amerigroup_OPPS": "54.57", "ARKANSASCOMMUNITYCARE_OPPS": "54.57", "Cigna-Healthspring_OPPS": "54.57", "GOLDENRULEINSCO_OPPS": "54.57", "HUMANACHOICEPPO_OPPS": "54.57", "HUMANAGOLD(MCRHMO)_OPPS": "54.57", "HUMANAGOLDPFFS_OPPS": "54.57", "MEDICARE_OPPS": "54.57", "MedicareAdvantageOther_OPPS": "54.57", "MedicareRailroad_OPPS": "54.57", "MEDIPAK_OPPS": "54.57", "MEDIPAKADVANTAGE_OPPS": "54.57", "MVPHEALTHCARE_OPPS": "54.57", "PYRAMID/MCRHMO_OPPS": "54.57", "QUALCHOICE_Outpatient": "36.4000", "QUALCHOICE_EmergencyRoom": "36.4000", "SECUREHORIZONS_OPPS": "54.57", "STERLINGOPTIONONE,STER_OPPS": "54.57", "TributeHealthPlan_OPPS": "54.57", "TRICAREEAST_OPPS": "54.57", "TRICAREFORLIFE_OPPS": "54.57", "TRICAREWEST_OPPS": "54.57", "UMR_OPPS": "54.57", "UNITEDHCOFRIVERVALLEY_OPPS": "54.57", "UNITEDHEALTHCARE_OPPS": "54.57", "UNITEDHEALTHCAREADVANTAGE_OPPS": "54.57", "UNITEDHEALTHCARECHOICE+GA_OPPS": "54.57", "UNITEDHEALTHCARECHOICE+UT_OPPS": "54.57", "UNITEDHEALTHCAREOTHER_OPPS": "54.57", "UnitedHealthcareSharedServ._OPPS": "54.57", "VACHAMPVA_OPPS": "54.57", "WEBTPAAetnaNonemployee_Outpatient": "57.2000", "WEBTPAAetnaNonemployee_EmergencyRoom": "57.2000", "WELLCAREHEALTHPLANS_OPPS": "54.57" }, { "Description": "REMOVAL OF NAIL PLATE", "ProcedureCode": "11730", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "428.00", "EmergencyRoomGrossCharge": "428.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "209.7200", "MinimumNegotiatedCharge": "176.02", "MaximumNegotiatedCharge": "376.6400", "AARPMedicareManagedCare_OPPS": "176.02", "ADVANTRAFREEDOM_OPPS": "176.02", "AETNA_Outpatient": "376.6400", "AETNA_EmergencyRoom": "376.6400", "AETNAMEDICAREADVANTAGE_OPPS": "176.02", "AETNAOTHER_Outpatient": "376.6400", "AETNAOTHER_EmergencyRoom": "376.6400", "Allwell_OPPS": "176.02", "Amerigroup_OPPS": "176.02", "ARKANSASCOMMUNITYCARE_OPPS": "176.02", "Cigna-Healthspring_OPPS": "176.02", "GOLDENRULEINSCO_OPPS": "176.02", "HUMANACHOICEPPO_OPPS": "176.02", "HUMANAGOLD(MCRHMO)_OPPS": "176.02", "HUMANAGOLDPFFS_OPPS": "176.02", "MEDICARE_OPPS": "176.02", "MedicareAdvantageOther_OPPS": "176.02", "MedicareRailroad_OPPS": "176.02", "MEDIPAK_OPPS": "176.02", "MEDIPAKADVANTAGE_OPPS": "176.02", "MVPHEALTHCARE_OPPS": "176.02", "PYRAMID/MCRHMO_OPPS": "176.02", "QUALCHOICE_Outpatient": "239.6800", "QUALCHOICE_EmergencyRoom": "239.6800", "SECUREHORIZONS_OPPS": "176.02", "STERLINGOPTIONONE,STER_OPPS": "176.02", "TributeHealthPlan_OPPS": "176.02", "TRICAREEAST_OPPS": "176.02", "TRICAREFORLIFE_OPPS": "176.02", "TRICAREWEST_OPPS": "176.02", "UMR_OPPS": "176.02", "UNITEDHCOFRIVERVALLEY_OPPS": "176.02", "UNITEDHEALTHCARE_OPPS": "176.02", "UNITEDHEALTHCAREADVANTAGE_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+GA_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+UT_OPPS": "176.02", "UNITEDHEALTHCAREOTHER_OPPS": "176.02", "UnitedHealthcareSharedServ._OPPS": "176.02", "VACHAMPVA_OPPS": "176.02", "WEBTPAAetnaNonemployee_Outpatient": "376.6400", "WEBTPAAetnaNonemployee_EmergencyRoom": "376.6400", "WELLCAREHEALTHPLANS_OPPS": "176.02" }, { "Description": "REMOVE NAIL PLATE ADD-ON", "ProcedureCode": "11732", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "362.00", "EmergencyRoomGrossCharge": "362.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "177.3800", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "318.5600", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "318.5600", "AETNA_EmergencyRoom": "318.5600", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "318.5600", "AETNAOTHER_EmergencyRoom": "318.5600", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "202.7200", "QUALCHOICE_EmergencyRoom": "202.7200", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "318.5600", "WEBTPAAetnaNonemployee_EmergencyRoom": "318.5600", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "REMOVAL OF NAIL BED", "ProcedureCode": "11750", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "3809.30", "EmergencyRoomGrossCharge": "3809.30", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "1866.5570", "MinimumNegotiatedCharge": "339.04", "MaximumNegotiatedCharge": "3352.1840", "AARPMedicareManagedCare_OPPS": "339.04", "ADVANTRAFREEDOM_OPPS": "339.04", "AETNA_Outpatient": "3352.1840", "AETNA_EmergencyRoom": "3352.1840", "AETNAMEDICAREADVANTAGE_OPPS": "339.04", "AETNAOTHER_Outpatient": "3352.1840", "AETNAOTHER_EmergencyRoom": "3352.1840", "Allwell_OPPS": "339.04", "Amerigroup_OPPS": "339.04", "ARKANSASCOMMUNITYCARE_OPPS": "339.04", "Cigna-Healthspring_OPPS": "339.04", "GOLDENRULEINSCO_OPPS": "339.04", "HUMANACHOICEPPO_OPPS": "339.04", "HUMANAGOLD(MCRHMO)_OPPS": "339.04", "HUMANAGOLDPFFS_OPPS": "339.04", "MEDICARE_OPPS": "339.04", "MedicareAdvantageOther_OPPS": "339.04", "MedicareRailroad_OPPS": "339.04", "MEDIPAK_OPPS": "339.04", "MEDIPAKADVANTAGE_OPPS": "339.04", "MVPHEALTHCARE_OPPS": "339.04", "PYRAMID/MCRHMO_OPPS": "339.04", "QUALCHOICE_Outpatient": "2133.2080", "QUALCHOICE_EmergencyRoom": "2133.2080", "SECUREHORIZONS_OPPS": "339.04", "STERLINGOPTIONONE,STER_OPPS": "339.04", "TributeHealthPlan_OPPS": "339.04", "TRICAREEAST_OPPS": "339.04", "TRICAREFORLIFE_OPPS": "339.04", "TRICAREWEST_OPPS": "339.04", "UMR_OPPS": "339.04", "UNITEDHCOFRIVERVALLEY_OPPS": "339.04", "UNITEDHEALTHCARE_OPPS": "339.04", "UNITEDHEALTHCAREADVANTAGE_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+GA_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+UT_OPPS": "339.04", "UNITEDHEALTHCAREOTHER_OPPS": "339.04", "UnitedHealthcareSharedServ._OPPS": "339.04", "VACHAMPVA_OPPS": "339.04", "WEBTPAAetnaNonemployee_Outpatient": "3352.1840", "WEBTPAAetnaNonemployee_EmergencyRoom": "3352.1840", "WELLCAREHEALTHPLANS_OPPS": "339.04" }, { "Description": "REPAIR OF NAIL BED", "ProcedureCode": "11760", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "7498.80", "EmergencyRoomGrossCharge": "7498.80", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "3674.4120", "MinimumNegotiatedCharge": "513.86", "MaximumNegotiatedCharge": "6598.9440", "AARPMedicareManagedCare_OPPS": "513.86", "ADVANTRAFREEDOM_OPPS": "513.86", "AETNA_Outpatient": "6598.9440", "AETNA_EmergencyRoom": "6598.9440", "AETNAMEDICAREADVANTAGE_OPPS": "513.86", "AETNAOTHER_Outpatient": "6598.9440", "AETNAOTHER_EmergencyRoom": "6598.9440", "Allwell_OPPS": "513.86", "Amerigroup_OPPS": "513.86", "ARKANSASCOMMUNITYCARE_OPPS": "513.86", "Cigna-Healthspring_OPPS": "513.86", "GOLDENRULEINSCO_OPPS": "513.86", "HUMANACHOICEPPO_OPPS": "513.86", "HUMANAGOLD(MCRHMO)_OPPS": "513.86", "HUMANAGOLDPFFS_OPPS": "513.86", "MEDICARE_OPPS": "513.86", "MedicareAdvantageOther_OPPS": "513.86", "MedicareRailroad_OPPS": "513.86", "MEDIPAK_OPPS": "513.86", "MEDIPAKADVANTAGE_OPPS": "513.86", "MVPHEALTHCARE_OPPS": "513.86", "PYRAMID/MCRHMO_OPPS": "513.86", "QUALCHOICE_Outpatient": "4199.3280", "QUALCHOICE_EmergencyRoom": "4199.3280", "SECUREHORIZONS_OPPS": "513.86", "STERLINGOPTIONONE,STER_OPPS": "513.86", "TributeHealthPlan_OPPS": "513.86", "TRICAREEAST_OPPS": "513.86", "TRICAREFORLIFE_OPPS": "513.86", "TRICAREWEST_OPPS": "513.86", "UMR_OPPS": "513.86", "UNITEDHCOFRIVERVALLEY_OPPS": "513.86", "UNITEDHEALTHCARE_OPPS": "513.86", "UNITEDHEALTHCAREADVANTAGE_OPPS": "513.86", "UNITEDHEALTHCARECHOICE+GA_OPPS": "513.86", "UNITEDHEALTHCARECHOICE+UT_OPPS": "513.86", "UNITEDHEALTHCAREOTHER_OPPS": "513.86", "UnitedHealthcareSharedServ._OPPS": "513.86", "VACHAMPVA_OPPS": "513.86", "WEBTPAAetnaNonemployee_Outpatient": "6598.9440", "WEBTPAAetnaNonemployee_EmergencyRoom": "6598.9440", "WELLCAREHEALTHPLANS_OPPS": "513.86" }, { "Description": "EXCISION OF NAIL FOLD TOE", "ProcedureCode": "11765", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "601.00", "EmergencyRoomGrossCharge": "601.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "294.4900", "MinimumNegotiatedCharge": "336.5600", "MaximumNegotiatedCharge": "528.8800", "AARPMedicareManagedCare_OPPS": "339.04", "ADVANTRAFREEDOM_OPPS": "339.04", "AETNA_Outpatient": "528.8800", "AETNA_EmergencyRoom": "528.8800", "AETNAMEDICAREADVANTAGE_OPPS": "339.04", "AETNAOTHER_Outpatient": "528.8800", "AETNAOTHER_EmergencyRoom": "528.8800", "Allwell_OPPS": "339.04", "Amerigroup_OPPS": "339.04", "ARKANSASCOMMUNITYCARE_OPPS": "339.04", "Cigna-Healthspring_OPPS": "339.04", "GOLDENRULEINSCO_OPPS": "339.04", "HUMANACHOICEPPO_OPPS": "339.04", "HUMANAGOLD(MCRHMO)_OPPS": "339.04", "HUMANAGOLDPFFS_OPPS": "339.04", "MEDICARE_OPPS": "339.04", "MedicareAdvantageOther_OPPS": "339.04", "MedicareRailroad_OPPS": "339.04", "MEDIPAK_OPPS": "339.04", "MEDIPAKADVANTAGE_OPPS": "339.04", "MVPHEALTHCARE_OPPS": "339.04", "PYRAMID/MCRHMO_OPPS": "339.04", "QUALCHOICE_Outpatient": "336.5600", "QUALCHOICE_EmergencyRoom": "336.5600", "SECUREHORIZONS_OPPS": "339.04", "STERLINGOPTIONONE,STER_OPPS": "339.04", "TributeHealthPlan_OPPS": "339.04", "TRICAREEAST_OPPS": "339.04", "TRICAREFORLIFE_OPPS": "339.04", "TRICAREWEST_OPPS": "339.04", "UMR_OPPS": "339.04", "UNITEDHCOFRIVERVALLEY_OPPS": "339.04", "UNITEDHEALTHCARE_OPPS": "339.04", "UNITEDHEALTHCAREADVANTAGE_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+GA_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+UT_OPPS": "339.04", "UNITEDHEALTHCAREOTHER_OPPS": "339.04", "UnitedHealthcareSharedServ._OPPS": "339.04", "VACHAMPVA_OPPS": "339.04", "WEBTPAAetnaNonemployee_Outpatient": "528.8800", "WEBTPAAetnaNonemployee_EmergencyRoom": "528.8800", "WELLCAREHEALTHPLANS_OPPS": "339.04" }, { "Description": "REMOVE PILONIDAL CYST EXTEN", "ProcedureCode": "11771", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "12589.53", "EmergencyRoomGrossCharge": "12589.53", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "6168.8697", "MinimumNegotiatedCharge": "2323.39", "MaximumNegotiatedCharge": "11078.7864", "AARPMedicareManagedCare_OPPS": "2323.39", "ADVANTRAFREEDOM_OPPS": "2323.39", "AETNA_Outpatient": "11078.7864", "AETNA_EmergencyRoom": "11078.7864", "AETNAMEDICAREADVANTAGE_OPPS": "2323.39", "AETNAOTHER_Outpatient": "11078.7864", "AETNAOTHER_EmergencyRoom": "11078.7864", "Allwell_OPPS": "2323.39", "Amerigroup_OPPS": "2323.39", "ARKANSASCOMMUNITYCARE_OPPS": "2323.39", "Cigna-Healthspring_OPPS": "2323.39", "GOLDENRULEINSCO_OPPS": "2323.39", "HUMANACHOICEPPO_OPPS": "2323.39", "HUMANAGOLD(MCRHMO)_OPPS": "2323.39", "HUMANAGOLDPFFS_OPPS": "2323.39", "MEDICARE_OPPS": "2323.39", "MedicareAdvantageOther_OPPS": "2323.39", "MedicareRailroad_OPPS": "2323.39", "MEDIPAK_OPPS": "2323.39", "MEDIPAKADVANTAGE_OPPS": "2323.39", "MVPHEALTHCARE_OPPS": "2323.39", "PYRAMID/MCRHMO_OPPS": "2323.39", "QUALCHOICE_Outpatient": "7050.1368", "QUALCHOICE_EmergencyRoom": "7050.1368", "SECUREHORIZONS_OPPS": "2323.39", "STERLINGOPTIONONE,STER_OPPS": "2323.39", "TributeHealthPlan_OPPS": "2323.39", "TRICAREEAST_OPPS": "2323.39", "TRICAREFORLIFE_OPPS": "2323.39", "TRICAREWEST_OPPS": "2323.39", "UMR_OPPS": "2323.39", "UNITEDHCOFRIVERVALLEY_OPPS": "2323.39", "UNITEDHEALTHCARE_OPPS": "2323.39", "UNITEDHEALTHCAREADVANTAGE_OPPS": "2323.39", "UNITEDHEALTHCARECHOICE+GA_OPPS": "2323.39", "UNITEDHEALTHCARECHOICE+UT_OPPS": "2323.39", "UNITEDHEALTHCAREOTHER_OPPS": "2323.39", "UnitedHealthcareSharedServ._OPPS": "2323.39", "VACHAMPVA_OPPS": "2323.39", "WEBTPAAetnaNonemployee_Outpatient": "11078.7864", "WEBTPAAetnaNonemployee_EmergencyRoom": "11078.7864", "WELLCAREHEALTHPLANS_OPPS": "2323.39" }, { "Description": "INJECT SKIN LESIONS ", "ProcedureCode": "17004", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "601.00", "EmergencyRoomGrossCharge": "601.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "294.4900", "MinimumNegotiatedCharge": "336.5600", "MaximumNegotiatedCharge": "528.8800", "AARPMedicareManagedCare_OPPS": "339.04", "ADVANTRAFREEDOM_OPPS": "339.04", "AETNA_Outpatient": "528.8800", "AETNA_EmergencyRoom": "528.8800", "AETNAMEDICAREADVANTAGE_OPPS": "339.04", "AETNAOTHER_Outpatient": "528.8800", "AETNAOTHER_EmergencyRoom": "528.8800", "Allwell_OPPS": "339.04", "Amerigroup_OPPS": "339.04", "ARKANSASCOMMUNITYCARE_OPPS": "339.04", "Cigna-Healthspring_OPPS": "339.04", "GOLDENRULEINSCO_OPPS": "339.04", "HUMANACHOICEPPO_OPPS": "339.04", "HUMANAGOLD(MCRHMO)_OPPS": "339.04", "HUMANAGOLDPFFS_OPPS": "339.04", "MEDICARE_OPPS": "339.04", "MedicareAdvantageOther_OPPS": "339.04", "MedicareRailroad_OPPS": "339.04", "MEDIPAK_OPPS": "339.04", "MEDIPAKADVANTAGE_OPPS": "339.04", "MVPHEALTHCARE_OPPS": "339.04", "PYRAMID/MCRHMO_OPPS": "339.04", "QUALCHOICE_Outpatient": "336.5600", "QUALCHOICE_EmergencyRoom": "336.5600", "SECUREHORIZONS_OPPS": "339.04", "STERLINGOPTIONONE,STER_OPPS": "339.04", "TributeHealthPlan_OPPS": "339.04", "TRICAREEAST_OPPS": "339.04", "TRICAREFORLIFE_OPPS": "339.04", "TRICAREWEST_OPPS": "339.04", "UMR_OPPS": "339.04", "UNITEDHCOFRIVERVALLEY_OPPS": "339.04", "UNITEDHEALTHCARE_OPPS": "339.04", "UNITEDHEALTHCAREADVANTAGE_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+GA_OPPS": "339.04", "UNITEDHEALTHCARECHOICE+UT_OPPS": "339.04", "UNITEDHEALTHCAREOTHER_OPPS": "339.04", "UnitedHealthcareSharedServ._OPPS": "339.04", "VACHAMPVA_OPPS": "339.04", "WEBTPAAetnaNonemployee_Outpatient": "528.8800", "WEBTPAAetnaNonemployee_EmergencyRoom": "528.8800", "WELLCAREHEALTHPLANS_OPPS": "339.04" }, { "Description": "DESTRUCT B9 LESION 1-14", "ProcedureCode": "17110", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "315.00", "EmergencyRoomGrossCharge": "315.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "154.3500", "MinimumNegotiatedCharge": "176.02", "MaximumNegotiatedCharge": "277.2000", "AARPMedicareManagedCare_OPPS": "176.02", "ADVANTRAFREEDOM_OPPS": "176.02", "AETNA_Outpatient": "277.2000", "AETNA_EmergencyRoom": "277.2000", "AETNAMEDICAREADVANTAGE_OPPS": "176.02", "AETNAOTHER_Outpatient": "277.2000", "AETNAOTHER_EmergencyRoom": "277.2000", "Allwell_OPPS": "176.02", "Amerigroup_OPPS": "176.02", "ARKANSASCOMMUNITYCARE_OPPS": "176.02", "Cigna-Healthspring_OPPS": "176.02", "GOLDENRULEINSCO_OPPS": "176.02", "HUMANACHOICEPPO_OPPS": "176.02", "HUMANAGOLD(MCRHMO)_OPPS": "176.02", "HUMANAGOLDPFFS_OPPS": "176.02", "MEDICARE_OPPS": "176.02", "MedicareAdvantageOther_OPPS": "176.02", "MedicareRailroad_OPPS": "176.02", "MEDIPAK_OPPS": "176.02", "MEDIPAKADVANTAGE_OPPS": "176.02", "MVPHEALTHCARE_OPPS": "176.02", "PYRAMID/MCRHMO_OPPS": "176.02", "QUALCHOICE_Outpatient": "176.4000", "QUALCHOICE_EmergencyRoom": "176.4000", "SECUREHORIZONS_OPPS": "176.02", "STERLINGOPTIONONE,STER_OPPS": "176.02", "TributeHealthPlan_OPPS": "176.02", "TRICAREEAST_OPPS": "176.02", "TRICAREFORLIFE_OPPS": "176.02", "TRICAREWEST_OPPS": "176.02", "UMR_OPPS": "176.02", "UNITEDHCOFRIVERVALLEY_OPPS": "176.02", "UNITEDHEALTHCARE_OPPS": "176.02", "UNITEDHEALTHCAREADVANTAGE_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+GA_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+UT_OPPS": "176.02", "UNITEDHEALTHCAREOTHER_OPPS": "176.02", "UnitedHealthcareSharedServ._OPPS": "176.02", "VACHAMPVA_OPPS": "176.02", "WEBTPAAetnaNonemployee_Outpatient": "277.2000", "WEBTPAAetnaNonemployee_EmergencyRoom": "277.2000", "WELLCAREHEALTHPLANS_OPPS": "176.02" }, { "Description": "CHEM CAUT OF GRANLTJ TISSUE", "ProcedureCode": "17250", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "441.00", "EmergencyRoomGrossCharge": "441.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "216.0900", "MinimumNegotiatedCharge": "176.02", "MaximumNegotiatedCharge": "388.0800", "AARPMedicareManagedCare_OPPS": "176.02", "ADVANTRAFREEDOM_OPPS": "176.02", "AETNA_Outpatient": "388.0800", "AETNA_EmergencyRoom": "388.0800", "AETNAMEDICAREADVANTAGE_OPPS": "176.02", "AETNAOTHER_Outpatient": "388.0800", "AETNAOTHER_EmergencyRoom": "388.0800", "Allwell_OPPS": "176.02", "Amerigroup_OPPS": "176.02", "ARKANSASCOMMUNITYCARE_OPPS": "176.02", "Cigna-Healthspring_OPPS": "176.02", "GOLDENRULEINSCO_OPPS": "176.02", "HUMANACHOICEPPO_OPPS": "176.02", "HUMANAGOLD(MCRHMO)_OPPS": "176.02", "HUMANAGOLDPFFS_OPPS": "176.02", "MEDICARE_OPPS": "176.02", "MedicareAdvantageOther_OPPS": "176.02", "MedicareRailroad_OPPS": "176.02", "MEDIPAK_OPPS": "176.02", "MEDIPAKADVANTAGE_OPPS": "176.02", "MVPHEALTHCARE_OPPS": "176.02", "PYRAMID/MCRHMO_OPPS": "176.02", "QUALCHOICE_Outpatient": "246.9600", "QUALCHOICE_EmergencyRoom": "246.9600", "SECUREHORIZONS_OPPS": "176.02", "STERLINGOPTIONONE,STER_OPPS": "176.02", "TributeHealthPlan_OPPS": "176.02", "TRICAREEAST_OPPS": "176.02", "TRICAREFORLIFE_OPPS": "176.02", "TRICAREWEST_OPPS": "176.02", "UMR_OPPS": "176.02", "UNITEDHCOFRIVERVALLEY_OPPS": "176.02", "UNITEDHEALTHCARE_OPPS": "176.02", "UNITEDHEALTHCAREADVANTAGE_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+GA_OPPS": "176.02", "UNITEDHEALTHCARECHOICE+UT_OPPS": "176.02", "UNITEDHEALTHCAREOTHER_OPPS": "176.02", "UnitedHealthcareSharedServ._OPPS": "176.02", "VACHAMPVA_OPPS": "176.02", "WEBTPAAetnaNonemployee_Outpatient": "388.0800", "WEBTPAAetnaNonemployee_EmergencyRoom": "388.0800", "WELLCAREHEALTHPLANS_OPPS": "176.02" }, { "Description": "DRAINAGE OF BREAST LESION", "ProcedureCode": "19000", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "4583.00", "EmergencyRoomGrossCharge": "4583.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "2245.6700", "MinimumNegotiatedCharge": "609.74", "MaximumNegotiatedCharge": "4033.0400", "AARPMedicareManagedCare_OPPS": "609.74", "ADVANTRAFREEDOM_OPPS": "609.74", "AETNA_Outpatient": "4033.0400", "AETNA_EmergencyRoom": "4033.0400", "AETNAMEDICAREADVANTAGE_OPPS": "609.74", "AETNAOTHER_Outpatient": "4033.0400", "AETNAOTHER_EmergencyRoom": "4033.0400", "Allwell_OPPS": "609.74", "Amerigroup_OPPS": "609.74", "ARKANSASCOMMUNITYCARE_OPPS": "609.74", "Cigna-Healthspring_OPPS": "609.74", "GOLDENRULEINSCO_OPPS": "609.74", "HUMANACHOICEPPO_OPPS": "609.74", "HUMANAGOLD(MCRHMO)_OPPS": "609.74", "HUMANAGOLDPFFS_OPPS": "609.74", "MEDICARE_OPPS": "609.74", "MedicareAdvantageOther_OPPS": "609.74", "MedicareRailroad_OPPS": "609.74", "MEDIPAK_OPPS": "609.74", "MEDIPAKADVANTAGE_OPPS": "609.74", "MVPHEALTHCARE_OPPS": "609.74", "PYRAMID/MCRHMO_OPPS": "609.74", "QUALCHOICE_Outpatient": "2566.4800", "QUALCHOICE_EmergencyRoom": "2566.4800", "SECUREHORIZONS_OPPS": "609.74", "STERLINGOPTIONONE,STER_OPPS": "609.74", "TributeHealthPlan_OPPS": "609.74", "TRICAREEAST_OPPS": "609.74", "TRICAREFORLIFE_OPPS": "609.74", "TRICAREWEST_OPPS": "609.74", "UMR_OPPS": "609.74", "UNITEDHCOFRIVERVALLEY_OPPS": "609.74", "UNITEDHEALTHCARE_OPPS": "609.74", "UNITEDHEALTHCAREADVANTAGE_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+GA_OPPS": "609.74", "UNITEDHEALTHCARECHOICE+UT_OPPS": "609.74", "UNITEDHEALTHCAREOTHER_OPPS": "609.74", "UnitedHealthcareSharedServ._OPPS": "609.74", "VACHAMPVA_OPPS": "609.74", "WEBTPAAetnaNonemployee_Outpatient": "4033.0400", "WEBTPAAetnaNonemployee_EmergencyRoom": "4033.0400", "WELLCAREHEALTHPLANS_OPPS": "609.74" }, { "Description": "DRAIN BREAST LESION ADD-ON", "ProcedureCode": "19001", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "1347.25", "EmergencyRoomGrossCharge": "1347.25", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "660.1525", "MinimumNegotiatedCharge": "0", "MaximumNegotiatedCharge": "1185.5800", "AARPMedicareManagedCare_OPPS": "0", "ADVANTRAFREEDOM_OPPS": "0", "AETNA_Outpatient": "1185.5800", "AETNA_EmergencyRoom": "1185.5800", "AETNAMEDICAREADVANTAGE_OPPS": "0", "AETNAOTHER_Outpatient": "1185.5800", "AETNAOTHER_EmergencyRoom": "1185.5800", "Allwell_OPPS": "0", "Amerigroup_OPPS": "0", "ARKANSASCOMMUNITYCARE_OPPS": "0", "Cigna-Healthspring_OPPS": "0", "GOLDENRULEINSCO_OPPS": "0", "HUMANACHOICEPPO_OPPS": "0", "HUMANAGOLD(MCRHMO)_OPPS": "0", "HUMANAGOLDPFFS_OPPS": "0", "MEDICARE_OPPS": "0", "MedicareAdvantageOther_OPPS": "0", "MedicareRailroad_OPPS": "0", "MEDIPAK_OPPS": "0", "MEDIPAKADVANTAGE_OPPS": "0", "MVPHEALTHCARE_OPPS": "0", "PYRAMID/MCRHMO_OPPS": "0", "QUALCHOICE_Outpatient": "754.4600", "QUALCHOICE_EmergencyRoom": "754.4600", "SECUREHORIZONS_OPPS": "0", "STERLINGOPTIONONE,STER_OPPS": "0", "TributeHealthPlan_OPPS": "0", "TRICAREEAST_OPPS": "0", "TRICAREFORLIFE_OPPS": "0", "TRICAREWEST_OPPS": "0", "UMR_OPPS": "0", "UNITEDHCOFRIVERVALLEY_OPPS": "0", "UNITEDHEALTHCARE_OPPS": "0", "UNITEDHEALTHCAREADVANTAGE_OPPS": "0", "UNITEDHEALTHCARECHOICE+GA_OPPS": "0", "UNITEDHEALTHCARECHOICE+UT_OPPS": "0", "UNITEDHEALTHCAREOTHER_OPPS": "0", "UnitedHealthcareSharedServ._OPPS": "0", "VACHAMPVA_OPPS": "0", "WEBTPAAetnaNonemployee_Outpatient": "1185.5800", "WEBTPAAetnaNonemployee_EmergencyRoom": "1185.5800", "WELLCAREHEALTHPLANS_OPPS": "0" }, { "Description": "INCISION OF BREAST LESION", "ProcedureCode": "19020", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "706.00", "EmergencyRoomGrossCharge": "706.00", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "345.9400", "MinimumNegotiatedCharge": "395.3600", "MaximumNegotiatedCharge": "1379.32", "AARPMedicareManagedCare_OPPS": "1379.32", "ADVANTRAFREEDOM_OPPS": "1379.32", "AETNA_Outpatient": "621.2800", "AETNA_EmergencyRoom": "621.2800", "AETNAMEDICAREADVANTAGE_OPPS": "1379.32", "AETNAOTHER_Outpatient": "621.2800", "AETNAOTHER_EmergencyRoom": "621.2800", "Allwell_OPPS": "1379.32", "Amerigroup_OPPS": "1379.32", "ARKANSASCOMMUNITYCARE_OPPS": "1379.32", "Cigna-Healthspring_OPPS": "1379.32", "GOLDENRULEINSCO_OPPS": "1379.32", "HUMANACHOICEPPO_OPPS": "1379.32", "HUMANAGOLD(MCRHMO)_OPPS": "1379.32", "HUMANAGOLDPFFS_OPPS": "1379.32", "MEDICARE_OPPS": "1379.32", "MedicareAdvantageOther_OPPS": "1379.32", "MedicareRailroad_OPPS": "1379.32", "MEDIPAK_OPPS": "1379.32", "MEDIPAKADVANTAGE_OPPS": "1379.32", "MVPHEALTHCARE_OPPS": "1379.32", "PYRAMID/MCRHMO_OPPS": "1379.32", "QUALCHOICE_Outpatient": "395.3600", "QUALCHOICE_EmergencyRoom": "395.3600", "SECUREHORIZONS_OPPS": "1379.32", "STERLINGOPTIONONE,STER_OPPS": "1379.32", "TributeHealthPlan_OPPS": "1379.32", "TRICAREEAST_OPPS": "1379.32", "TRICAREFORLIFE_OPPS": "1379.32", "TRICAREWEST_OPPS": "1379.32", "UMR_OPPS": "1379.32", "UNITEDHCOFRIVERVALLEY_OPPS": "1379.32", "UNITEDHEALTHCARE_OPPS": "1379.32", "UNITEDHEALTHCAREADVANTAGE_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+GA_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+UT_OPPS": "1379.32", "UNITEDHEALTHCAREOTHER_OPPS": "1379.32", "UnitedHealthcareSharedServ._OPPS": "1379.32", "VACHAMPVA_OPPS": "1379.32", "WEBTPAAetnaNonemployee_Outpatient": "621.2800", "WEBTPAAetnaNonemployee_EmergencyRoom": "621.2800", "WELLCAREHEALTHPLANS_OPPS": "1379.32" }, { "Description": "BX BREAST 1ST LESION STRTCT", "ProcedureCode": "19081", "Modifier": null, "RevenueCode": null, "MSDRG": null, "NDC": null, "InpatientGrossCharge": null, "OutpatientGrossCharge": "3090.25", "EmergencyRoomGrossCharge": "3090.25", "MSDRGAverageGrossCharge": null, "DiscountedCashPrice": "1514.2225", "MinimumNegotiatedCharge": "1379.32", "MaximumNegotiatedCharge": "2719.4200", "AARPMedicareManagedCare_OPPS": "1379.32", "ADVANTRAFREEDOM_OPPS": "1379.32", "AETNA_Outpatient": "2719.4200", "AETNA_EmergencyRoom": "2719.4200", "AETNAMEDICAREADVANTAGE_OPPS": "1379.32", "AETNAOTHER_Outpatient": "2719.4200", "AETNAOTHER_EmergencyRoom": "2719.4200", "Allwell_OPPS": "1379.32", "Amerigroup_OPPS": "1379.32", "ARKANSASCOMMUNITYCARE_OPPS": "1379.32", "Cigna-Healthspring_OPPS": "1379.32", "GOLDENRULEINSCO_OPPS": "1379.32", "HUMANACHOICEPPO_OPPS": "1379.32", "HUMANAGOLD(MCRHMO)_OPPS": "1379.32", "HUMANAGOLDPFFS_OPPS": "1379.32", "MEDICARE_OPPS": "1379.32", "MedicareAdvantageOther_OPPS": "1379.32", "MedicareRailroad_OPPS": "1379.32", "MEDIPAK_OPPS": "1379.32", "MEDIPAKADVANTAGE_OPPS": "1379.32", "MVPHEALTHCARE_OPPS": "1379.32", "PYRAMID/MCRHMO_OPPS": "1379.32", "QUALCHOICE_Outpatient": "1730.5400", "QUALCHOICE_EmergencyRoom": "1730.5400", "SECUREHORIZONS_OPPS": "1379.32", "STERLINGOPTIONONE,STER_OPPS": "1379.32", "TributeHealthPlan_OPPS": "1379.32", "TRICAREEAST_OPPS": "1379.32", "TRICAREFORLIFE_OPPS": "1379.32", "TRICAREWEST_OPPS": "1379.32", "UMR_OPPS": "1379.32", "UNITEDHCOFRIVERVALLEY_OPPS": "1379.32", "UNITEDHEALTHCARE_OPPS": "1379.32", "UNITEDHEALTHCAREADVANTAGE_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+GA_OPPS": "1379.32", "UNITEDHEALTHCARECHOICE+UT_OPPS": "1379.32", "UNITEDHEALTHCAREOTHER_OPPS": "1379.32", "UnitedHealthcareSharedServ._OPPS": "1379.32", "VACHAMPVA_OPPS": "1379.32", "WEBTPAAetnaNonemployee_Outpatient": "2719.4200", "WEBTPAAetnaNonemployee_EmergencyRoom": "2719.4200", "WELLCAREHEALTHPLANS_OPPS": "1379.32" } ] } }